“[i]f a patient ….interrupts the speaker, she must be told to keep silence and to listen; and must be told, moreover…in such a manner as to convey the speaker’s full conviction that the command will be immediately obeyed.”
Nineteenth century psychiatrists rejected any linguistic discourse that they considered to be nonsensical, particularly if the speech was female and therefore more prone to irrationality. Consequently, rather than the physician utilising dialogue to discover what the patient’s hysteria attempted to convey, it was instead used as a form of regulation and coercion. This reflected contemporary ideologies of female silence and submission and psychiatric authorities denied the hysteric’s subjectivity by translating their discourse into masculine language. This accordingly ‘silenced the female patient…mak[ing] her the object of techniques of moral management, or of photographic representation and interpretation’ However, subjecting a medical, supposedly organic condition to moral instruction destabilised the division between science and ontology, creating an inevitable value-conflict. This in turn threatened the medical establishment’s claim to authority derived from scientific evidence.
For women during the Victorian era the silence that was enforced within the domestic sphere prevented the vocal expression of emotion and resulted in a sense of suffocation. Therefore, one of the primary symptoms of hysteria was the sensation of ‘choking from a ball rising in the throat’ as if the ability to speak was being strangled. This was initially observed in the first century AD by Aretaeus who contended that:
the uterus is liable to be suddenly carried upward within the abdominal cavity. Violently compressing the vital organs, it gives rise to “hysterical suffocation”- a choking sensation leading to a fainting fit.
This was later diagnosed by Edward Jorden as Suffocation of the Mother, owing to its association with strangulation and choking which rendered the sufferer ‘[i]n priuation of voice and fpeech’. Suffocation of the Mother is exemplified by Braddon’s Lady Audley whose words when she attempted to speak ‘died away inarticulately upon her trembling lips’, a ‘choking sensation in her throat seem[ing] to strangle those false and plausible words’.
While the masculine order attempted to attribute the phenomenon of Suffocation of the Mother to the strangulating maternal bond, contemporary literature places the blame upon patriarchy itself. Lady Audley’s fear of mental suffocation and of ‘hands clutching at the black ribbon about her throat, as if it had been strangling her’ following Sir Michaels’ proposal accompanies the expectation of her identity and independence being subsumed within that of her prospective husband. While Lady Audley experiences suffocation when she awakes screaming in terror from ‘“a dream in which [she] had felt [her] mother’s icy grasp upon [her] throat”’ it is the prospect of hereditary hysteria rather than the maternal bond that seems to cause her panic. In Stoker’s Dracula patriarchal responsibility for female suffocation is rendered more explicit through the violent metaphor of vampirism. Constraining and wounding of the throat is a prevalent image throughout the novel, most striking when the masculine figure of Count Dracula feeds from the blood of Lucy Westenra. Contrastingly, the hysterical woman occupies the opposite position, being herself ‘“a vampire who sucks the blood of the healthy people [, the medical practioners,] around her”’. This occurs within Stoker’s text when Lucy Westenra requires repeated transfusions, causing the male donors to experience their ‘own life blood drawn away into the veins of the woman’.
While the masculine order may remove the possibility of meaningful feminine speech it cannot expel, only repress, transgressive female emotion that is instead psychosomatically released via hysteria. In Jane Austen’s Sense and Sensibility upon receiving Willoughby’s letter Marianne Dashwood ‘almost screamed with agony’, yet the social prohibitions against female vocalisation and the pressure of public conformity force her to resist articulation. Marianne is conditioned to conceal her passion whose expression would challenge both patriarchal power and contemporary gender conceptions of feminine passivity and masculine agency. However, in spite of such repression the transgressive emotion remains:
[t]he more her protestations of grief must be concealed and contained by an enforced Silence of public propriety and passivity, the more eloquently violent does that Silence become.
Instead of utilising vocal expression, Marianne articulates through the transgressive ‘violence’ of hysteria during which she ‘raves incoherently’ and in doing so discovers a form of release that she had previously been denied.
Such psychosomatic communication compelled the hegemonic order ‘to decipher its signs’ in an attempt to convert non-verbal communication into a patriarchally intelligible form. By the nineteenth century responsibility for such interpretation had become the province of the medical establishment since ‘[h]ysteria need[ed] a doctor or theorist, an authority figure who can give it a compelling name and narrative’. Therefore, by diagnosing the hysteric according to medical discourse, her incomprehensible behaviour was translated into the language of the masculine domain. As patriarch of the Brontë household, Reverend Patrick was preoccupied:
with the threat of nervous disease and insanity. Mind and body were subject to minute scrutiny and medical intervention. Patrick threw his whole weight of patriarchal endorsement behind the authority of the medical world.
While her father translated physical female behaviour into masculine written language, Charlotte Brontë created characters that acted to the contrary. The masculine language with which Catherine Earnshaw carves her name into the window ledge becomes a hysterical manifestation when the ‘white letters’ assume a physical form ‘start[ing] from the dark, as vivid as spectres’. In spite of masculine control and regulation, female communication assumes the form of psychosomatic, hysterical expression that resists fixed interpretation.
In order to control the fluid, amorphous quality of hysteria and its disordered expression, psychiatrists such as Jean-Martin Charcot attempted to isolate it ‘as a pure nosological object’ using the rigid rules of masculine, symbolic language. In his clinic in the Paris hospital La Salpêtrière that Victor Hugo describes as ‘part woman’s prison and part mad-house’, Charcot endeavoured to render hysteria coherent to male thought. By organising and identifying each hysterical symptom Charcot composed a list of distinct ‘grammatical components’ analogous to those forming the sentences of masculine language. Thus a catalogue, a microcosmic reflection of the entire medical, epistemological project, was compiled which interpreted physical symptoms according to masculine perception. This tableau categorised:
secretions of all kinds, saliva, drool, foam, sweat, “milky secretions,” tears, and urine, “blood sweats”: and finally what was called “vaginal or uterine hypersecretion”.
Similarly, Le Brun interpreted female bodily language according to a phallocentric perspective by translating hysterical behaviour into an alphabet, ‘count[ing] them only up to twenty-four’, ‘perhaps terrified of this in fact transfinite mathematics, the mathematics of symptoms that he had lighted upon.’
However, with the advent of psychoanalytic discourse, a fundamental problem with such a taxonomical approach became apparent as, owing to the mimetic propensity of nervous disorders, ‘identical signs in two different bodies do not have the same meaning’. Thus, owing to its ‘flowing, fluctuating …[b]lurring’ multiplicity of meanings that varied according to the individual, hysterical discourse resisted categorisation. Such resistance posed a problem since medical authorities only accepted communication that could be ordered according to symbolic masculine language. However, by endeavouring to universalise the individuality of hysterical discourse the subjective meaning became lost. Thus psychosomatic hysterical communication continued to defy medical intelligibility since it could not be categorised within the terms of the dominant discourse.
Owing to the impossibility of containing hysteria within masculine language, physicians attempted to limit the possible range of psychosomatic behaviour by placing the body to complete rest. While the rest cure developed by S. Weir Mitchell in 1872 was originally intended to treat soldiers suffering from battle fatigue, it was latterly applied to hysterics to prevent psychosomatic communication, consisting of ‘complete rest, seclusion, and excessive feeding’. Under the rest cure ‘the Victorian woman regressed physically and emotionally…she was put to bed and taught complete submission, even her arms and legs were moved for her’. This is exemplified by Charlotte Perkins Gilman’s The Yellow Wallpaper of which Ann Lane writes:
[the r]igidly enforced confinement and absolute passivity…contributed strongly to the madness in her short story, [that] needed to be discarded, as Gilman herself had discarded them, if women were to achieve sanity and strength.
Gilman explores the potential consequence of denying women their own language as during the rest cure they are told ‘how to express her thoughts’ and her protagonist is ‘absolutely forbidden to “work” until [she is] well again’, thus prohibited from expressing her mental affliction even through the medium of masculine written discourse. Gilman’s narrator states that her husband has diagnosed her condition as ‘only nervousness’ as she laments the fact that he ‘does not know how much [she] really suffer[s]’ . Owing to the strict regime of the rest cure the narrator is unable to convey the true nature of her suffering:
he does not believe I am sick! And what can one do? If a physician of high standing, and one’s own husband, assures friends and relatives that there is really nothing the matter with one but temporary nervous depression – a slight hysterical tendency – what is one to do?
Rather than allowing the narrator agency over her own physical movement, the rest cure grants expressive control of her body to her husband who, as both her spouse and physician, is doubly her patriarch.
However, as Gilman’s narrative portrays, it is only the outward expression of hysteria that is contained while the emotional frustration increases during confinement. Following her hysterical fit in the red-room, Jane Eyre is compelled to rest and is fed treats by Bessie who tempts her with ‘a tart on a certain brightly painted china plate’. Yet Jane rejects the rest cure claiming that she ‘could not eat the tart’, her hysteria instead increasing to assume the form of vocal protest when she verbally attacks Mrs Reed. Since during the period of immobility the hysteric is denied any opportunity for psychosomatic expression of mental affliction, once permission is finally granted movement results in an increasingly intense hysterical outburst.
The failure both of cataloguing and restricting mobility indicated that another approach was required, thus, between 1895 and 1900 Sigmund Freud attempted to limit hysteria’s transgressive potential by means of psychoanalysis. Through utilising the medium of narrative rather than quantification the psychoanalyst was able to contain hysteria within patriarchal symbols and archetypes. Freud defined the condition as a ‘somatic representation of a repressed bisexual conflict’ that led to hysterical behaviour when the masculine and feminine competed for dominance within the individual, expounding his theory using myths and symbols. However, while psychoanalysis encompassed hysteria within masculine discourse the subjective nature of the technique emphasised the problem of deducing ‘internal’ states from ‘external’ behaviours. Since the medical establishment derived its authority from contemporary scientific discourse, the subjective nature of psychoanalysis and its quasi-mystical use of mythology consequently destabilised this epistemological basis.
Therefore, in spite of the various attempts at containment and re-inscription deployed by the medical establishment to limit hysterical communication, the condition resisted masculine restraint. Since patriarchy refused to validate or explore hysteria as a form of ontological, psychosomatic communication, it remained a permanent challenge to the Victorian medical project. Owing to its fluid and idiosyncratic nature hysteria denied both patriarchy’s claim to the Cartesian binary and to predict ‘internal’ states from ‘external’ phenomena. Thus:
[t]he diagnosis of moral insanity was not a straightforward affair of decoding outer signs, but rested crucially on the observers interpretation and assessment of the relationship between outward behaviour and inner motivation.
Rather than resting upon the ‘certainties’ of epistemological data, conceptions of hysteria were merely nominal. Women accordingly became trapped within psychological discourse, which, as Irigaray states, reveals only the truth of masculine power and women’s position within such a model:
[p]sychoanalytic discourse on female sexuality is the discourse of truth. A discourse that tells the truth about the logic of truth: namely that the feminine occurs only within models and laws devised by male subjects.
Therefore, while the physician provided women with an unconscious, it is the unconscious of the patriarchal power structure: as Christine Von Braun states, the physicians ‘came to project their historically specific imaginations of what the feminine body should be onto their patients.’ The hysteric was thus devised by the psychiatrist as a physical body rather than a thinking being. Consequently, woman remained unknowable as, rather than endeavouring to understand her, the physician and psychoanalyst instead inscribed their own discourse upon her, and in doing so undermined the certainty of the patriarchal medical establishment.
 R.B. Carter, Pathology and Treatment of Hysteria (London: John Churchill, 1853), p.43 in, E. Showalter, The Female Malady (London: Virago Press, 2004), p.154
 E. Showalter, The Female Malady (London: Virago Press, 2004), p.154
 A.T. Schofield, A.T., Nerves in Disorder: A Plea for Rational Treatment (London: Hodder and Stoughton, 1903), p.96
 A.R.G. Owen, Hysteria, Hypnosis and Healing: The Work of J.-M. Charcot (New York: Garrett Publications, 1971), p.58
 E. Jorden, ‘A Briefe Discourse of a Disease called the Suffocation of the Moether’, in M. MacDonald, ed., Witchcraft and Hysteria in Elizabethan London: Edward Jorden and the Mary Glover Case (London: Routledge, 1991), p.16
 M.E. Braddon, Lady Audley’s Secret (Oxford: Oxford University Press, 1998), I, chapter 12
 ibid, I, chapter 12
 Braddon, Lady Audley’s Secret, I, chapter 1
 ibid, II, chapter 3
 S. Weir Mitchell, Fat and Blood: An Essay on the Treatment of Certain Forms of Neurasthenia and Hysteria, 4th edn, (Philadelphia, 1885), p.49 in, C. Gallagher and T. Laqueur, eds., The Making of the Modern Body: Sexuality and Society in the Nineteenth Century (London: University of California Press, 1987), p.153
 B. Stoker, Dracula (London: Penguin Books, 1994), chapter 10
 J. Austen, Sense and Sensibility in, The Complete Novels of Jane Austen (London: The Penguin Group, 1996), chapter 29
 A. Leighton, ‘Sense and Silences, Reading Jane Austen Again’, in, J. Todd, ed., Jane Austen: New Perspectives: Women and Literature, 3 vols (New York: Holmes and Meier, 1983), p.135, italics mine
 ibid, p.135
 S. Shuttleworth, Charlotte Brontë and Victorian Psychology (Cambridge: Cambridge University Press, 1996), p.39
 Showalter, Hystories, p.11
 Shuttleworth, Charlotte Brontë and Victorian Psychology, p.11
 E. Brontë, Wuthering Heights (London: Penguin Books, 1995), I, chapter 3
 ibid, I, chapter 3
 G. Didi-Huberman, Invention of Hysteria: Charcot and the Photographic Iconography of the Salpêtrière, trans. by A. Hartz (London: The MIT Press, 2004), p.19
 V. Hugo, Les Misérables (London: Penguin Books, 1982), p.388
 P. Briquet, Traité clinique et thérapeutique de l’hystérie (Paris: Ballière, 1859), pp.479-89, in G. Didi-Huberman, Invention of Hysteria: Charcot and the Photographic Iconography of the Salpêtrière, trans. by A. Hartz (London: The MIT Press, 2004), p.272
 G. Didi-Huberman, Invention of Hysteria: Charcot and the Photographic Iconography of the Salpêtrière, trans. by A. Hartz (London: The MIT Press, 2004), p.37
 ibid, p.37
Logan, Nerves and Narratives, p.22
 L. Irigaray, This Sex which is Not One, trans. by C. Porter (New York: Cornell University Press, 1985), p.152
 J. Mitchell, Mad Men and Medusas: Reclaiming Hysteria and the Effects of Sibling Relations on the Human Condition (London: The Penguin Group, 2000), p.247
 ibid, p.247
 ibid, p.252
 A.J. Lane, ed., The Charlotte Perkins Gilman Reader (London: University Press of Virginia, 1999), p.xxiv
 Mitchell, Mad Men and Medusas, p.252
 C. P. Gilman, ‘The Yellow Wallpaper’ in, D.S. Davies, ed., Short Stories from the Nineteenth Century (Hertfordshire: Wordsworth, 2000), p.193
 ibid, p.194
 Gilman, ‘The Yellow Wallpaper’, p.194
 Gilman, ‘The Yellow Wallpaper’, p.193
 C. Brontë, Jane Eyre (London: Penguin Books, 1996), I, chapter 3
 ibid, I, chapter 3
 S. Freud, ‘Hysterical Phantasies and Their Relation to Bisexuality’ in, Standard Edition of the Complete Psychological Works, 24 vols, ed. by James Strachey and others (London: The Hogarth Press and the Institute of Psychoanalysis, 1959) in, C. Kahane, Hysteria, Narrative, and the Figure of the Speaking Woman 1850-1915 (London: The Johns Hopkins Press, 1995), p.xi
 Shuttleworth, Charlotte Brontë and Victorian Psychology, p.49
 Irigaray, This Sex which is Not One, p.86
 C. Von Braun, Nicht loh (Frankfurt am Main: Verlang Neue Kritik, 1985) in, E. Bronfen, The Knotted Subject: Hysteria and its Discontents (New Jersey: Princeton University Press, 1998), p.115 at