Paul Verhaeghe – Psychotherapy, Psychoanalysis and Hysteria

THE LETTER 02 (Autumn 1994) pages 47-68

It is common knowledge that Freud started as the pupil of his hysterical patients. He wanted to know and that’s why he kept on listening to them. During that time, he coined the idea of psychotherapy, which was rather new at the end of the nineteenth century. Today, psychotherapy has become a very common practice; it is even so common, that no-one knows any longer what exactly it means. On the other hand, hysteria as such has almost disappeared, so much so that in the latest version of the DSM, the Diagnostic and Statistical manual, there is no longer any mention of it.

This means that my paper is on the one hand about something that does not exist any more, and on the other hand about something that exists far too much… So, it will be necessary to define what we, from the psychoanalytic point of view, understand by the word “psychotherapy” and what we consider hysteria to be.

Let us start with a common clinical situation. A client comes to see us because he has a symptom that has become unbearable. Within the context of hysteria, this symptom could be almost anything, starting with classical conversion, phobic complaints, sexual and/or relational problems, and ending with the more vague complaints of depression or discontent. The patient presents his problem to the therapist, and the normal expectation would be that therapeutical efforts will result in the disappearance of the symptoms and in a return to the status quo ante, the previous state of health.

This is, of course, a very naive point of view. It is very naive because it does not bring into account a remarkable little fact, namely that in most cases, the symptom is not an acute one, on the contrary, it’s rather…

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