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Post Sicosis (Spanish), Psychosis (English)...and Hysteria
Created by John Eipper on 05/22/20 5:12 AM

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Sicosis (Spanish), Psychosis (English)...and Hysteria (Arturo Ezquerro, UK, 05/22/20 5:12 am)

Thank you, Gary Moore and John Eipper, for your warm welcome--much appreciated.

You are right. Sycosis is an inflammation of the hair follicles, usually of the beard. At my medical school in Spain, in the late 1970s, the diagnosis "sicosis de la barba" was widely used, but not so much now. In colloquial terms, ordinary people tend now to use the term "sicosis" or "psicosis" to refer to a collective state of very high levels of anxiety or panic. Sometimes this "psicosis" ends in tragedy (e.g., when a large group tries to get out of a football stadium and the people at the front are crushed against the doors by the weight of the people behind them). At other times, it is as surreal as a Luis Buñuel movie (e.g., the supermarket toilet-paper collective psychosis at the beginning of the coronavirus crisis in London).

In the UK, the term "psychosis" is generally used as an individual psychiatric diagnosis, denoting serious disorders of the mind which are marked by a loss of touch with "reality" (which indeed means different things for different people at different times). Unfortunately, sometimes, psychosis becomes a construct to exclude vulnerable people.

The expression "mass hysteria" is widely used by ordinary people (and by the media) in the UK. But there is some history to this. In 1885, the young Freud went to Paris to study with Charcot and was haunted by his clinical presentations of patients with "hysteria"--at the time, the neurotic condition par excellence. Hysteria is a Greek word for uterus. In ancient times physicians believed that the disease was caused by body wandering of the uterus. It was Pierre Janet who first described the traumatic origin of hysterical symptoms and laid the foundation for a new understanding of the impact that traumatic events have on mind and body.

Freud's first attempt to explain hysterical symptoms appeared in the book Studies on Hysteria that he co-authored with his mentor Josef Breuer, in 1895. The book was based on their clinical observations about a number of patients with a diagnosis of hysteria. Breuer saw the symptoms as reactions to emotional trauma. Freud went further than that and considered that repressed memories of sexual-related trauma may play a part in the formation of the hysterical symptoms.

In 1896, Freud presented his controversial paper "The Aetiology of Hysteria" to the Society for Psychiatry and Neurology of Vienna. He detailed the stories of eighteen patients, twelve women and six men. He made more direct links than in the Hysteria book between the patient's symptoms and childhood sexual trauma. Freud's so-called seduction theory was born; but it would be short-lived. Most of his colleagues rejected the paper; they did not accept that childhood sexual abuse in the family could have actually occurred. Some even accused him of putting these ideas into his patients' minds. And Krafft-Ebing, who chaired the meeting, commented that the presentation sounded as a scientific fairy-tale... We may say "de aquellos polvos, estos lodos."

JE comments:  "From that dust, this mud"--you shall reap what you sow?  Hysteria, together with the "humor"-related medical terms (melancholic, choleric, phlegmatic, sanguine) have lost their clinical precision but remain in popular use.  "Hysteria" is especially problematic as a medical term, given its previous association with women only.  In the "uterus era" of hysteria diagnoses, how was male hysteria explained?

So grateful for your inaugural WAIS post, Arturo!  We'll no doubt be asking you many questions as we muddle through this era of collective psychosis.

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  • Welcoming Arturo Ezquerro; Erik Erikson (Leo Goldberger, USA 05/23/20 4:48 AM)
    I, too, want to welcome Arturo Ezquerro with great pleasure as a psychoanalytic colleague!

    By the way, I still recall our personal meeting when he visited the Austen Riggs Center in Stockbridge, Massachusetts, where I served as a research consultant (while Erik Erikson was still there as well). Erikson's long career spanned so many significant issues and topics--such as his little-known efforts on behalf of the Jewish Kindertransport following WWII and his association with the WHO, not to mention his major theoretical, groundbreaking work on separation of children from their parents that has been such a major topic in our time.

    Were we to provide the WAIS readers an overview of this great man's work, I believe it would be most appreciated.  As the major figure he was in psychiatry, certainly he deserves to be better known to the world at large.

    JE comments:  It's a small (WAIS) world!  I'm delighted that with Drs Ezquerro and Goldberger, WAIS has power hitters in its psychoanalytic lineup.  It would be very enlightening to learn more about Erik Erikson (1902-1994).  I just discovered from Google that he gave us the term "identity crisis," which may be the most perfect descriptor of world culture since about 1968.

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    • A Correction: Psychologist John Bowlby (Leo Goldberger, USA 05/24/20 3:57 AM)

      A major correction to my post of May 23rd.

      It was John Bowlby whom I met.  Bowlby had been one of Dr Arturo Ezquerro's chief mentors and
      influences (not Erik Erikson, whom I happened to have worked with at Riggs when
      Bowlby came from London for a visit to Stockbridge, Massachusetts). My
      apologies; it demonstrates that one's age
      does creep in on one's focused memory!

      PS. A clarification: I only mentioned Erik Erikson in passing, as he was connected with the Riggs Psychiatric Center at the time of Bowlby's visit, and they obviously knew each another.
      As John E has looked up Erikson, he should know he was the first and only psychoanalyst ever featured on the cover of Newsweek magazine, for his work on the concept of "identity" that became such a popular notion--just as Bowlby's work on "attachment" theory has become within our field--though not as well-known as Erikson's work.

      This was the reason for my appeal to Arturo to write about Bowlby--who most certainly ought to become better known beyond our profession.
      (By the way, I got to know Erik Erikson quite well while I was a research consultant at Riggs. I also served as co-editor (with Robert Wallerstein) of a Festschrift, entitled: Ideas and Identities: The Life and Work of Erik Erikson (IUP, 1998).

      JE comments:  Thank you for the clarification, Leo!  I found the Newsweek cover, from 1970.  The timing is significant, as it came on the tail end of the decade that brought a major shift in the search for identity:  the 1960s. 

      As for Dr Bowlby, I hope that when time permits, Arturo Ezquerro will give us a Beginner's Guide to attachment theory.  From my layman's perspective, attachment and identity are fundamentally intertwined:  can you have one without the other?

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      • John Bowlby, Erik Erikson, and Attachment Theory (Arturo Ezquerro, UK 05/26/20 4:30 AM)
        My thanks to Leo Goldberger for re-connecting. I am pleased to know about his familiarity with Erik Erikson, a great man. He and John Bowlby (my mentor) were good friends.

        They both provided psychoanalysis with a developmental perspective across the life-cycle. In the early 1950s, Bowlby collaborated closely with the WHO and eventually set up a study group on the Psychobiology of the Child. This was a forum of world experts who met monthly in Geneva, between 1953 and 1956. Besides Bowlby and Erikson, the meetings were attended by Ludwig von Bertalanffy, Julian Huxley, Jean Piaget, Margaret Mead, Konrad Lorenz, James Tanner, Barbel Inhelder and others. Initially, Bowlby was the only advocate of psychoanalysis among this group of psychiatrists, psychologists, research fellows, biologists, cultural anthropologists, ethologists and electro-physiologists.

        Erikson would join the group soon. He had originally specialized in child analysis and underwent a training analysis with Anna Freud. He became widely respected and quoted across a wide range of disciplines. His theory on psychosocial development as an open-ended task, and his concept of "identity crisis," have made sense to professionals, patients and public all the way through generations. He and Bowlby seemed to be on a similar wavelength, and jointly proved that psychoanalytic notions and attachment ideas didn't need to be at war.

        In the WHO's study group, Erikson connected meaningfully with Bowlby and tried to integrate attachment ideas with his own thinking. He had a rare ability to put complex things simply; look at this: "The baby will certainly feel secure only with one or two persons, especially at critical times. Each of the stages which I outlined coincides with an extension of the social radius of interaction: from the family to the known 'world.' Therefore, with each crisis, security has to be re-established within a wider radius, from a mother or maternal person to that of parental persons in general... to the basic family, to the neighbourhood, to the peer group, to the apprenticeship organization and so on. Each of the early securities is basic for the later one, but it has first to find its own establishment in its own social radius."

        In the above quote, Erikson gives a powerful description of a developmental perspective in the understanding of identity crisis, as well as of the evolving nature of human attachment.

        John: thank you for the Newsweek cover featuring Erikson. It's splendid. I agree with you that attachment and identity are fundamentally intertwined. Bowlby made it explicit that personal identity is necessarily configured through mental representations of interactions and attachment relationships with other people and with groups, as well as with the places where the person was born and where he or she has lived.

        JE comments:  Fascinating, Arturo.  Your work with Dr Bowlby not only explains the importance of Attachment Theory, but also exemplifies it.  The "mentor/protégé" relationship is possibly the final/highest stage of the hierarchy you describe above. 

        Those Geneva meetings in the 1950s read like a Who's Who of psychology/psychiatry.  In our present era of hyper-specialization, it would be unthinkable to assemble so many heavy hitters in one place.  Did any definitive conclusions or agreements come out of Geneva?

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