Put it all down to hysteria

Only a limited number of people believe tales of alien abduction and satanic abuse. Gulf war syndrome and ME, on the other hand, are widely regarded as real afflictions which demand physiological explanation. But to Elaine Showalter they are as one. By Jack O'Sullivan

"Hysteria not only survives in the 1990s, it is more contagious than in the past. Infectious diseases spread by ecological change, modern technology, urbanisation, jet travel and human interaction. Infectious epidemics of hysteria spread by stories circulated through self-help books, articles in newspapers and magazines, TV talk shows and series, films, the Internet and even literary criticism. The cultural narratives of hysteria, which I call hystories, multiply rapidly and uncontrollably in the era of mass media, telecommunications and e-mail."

Elaine Showalter, 56, respected feminist academic raised in Boston, near Salem, site of witch hunts in the 17th century, has long had a thing about hysteria. Reading her new book Hystories you might think that the strength with which she cleaves to the idea of hysteria as an explanation for many modern maladies itself verges on the hysterical.

Plagued with ME - chronic fatigue syndrome? Think the unrelieved tiredness, the endless aches, the nausea and the low-grade fevers all point to an organic cause? Ms Showalter, a Professor of English at Princeton, knows different. Forget physiology. It's all in the mind.

The same goes for Gulf war syndrome - the thousands of veterans (and some of their families) are, she contends, enduring not the after-effects of a chemical overdose, but the psychosomatic symptoms of war neurosis.

ME and Gulf war syndrome, says Showalter, come from the same psychological bucket as recovered memory syndrome, multiple personality syndrome and memories of satanic ritual abuse and alien abduction.

All are, she says, examples of hysteria - deep-rooted psychological problems presented in a physical form that fashion and culture of the day finds socially acceptable. Many and various are the afflictions that Showalter sees as one.

If you want to understand why these unexplained illnesses and happenings are everywhere, look no further, she says, than our continuing lack of sympathy for mental problems combined with the mass publicity given to various physical conditions and beliefs.

Today's hysterias are created, she argues by a unwitting alliance of those who mean well - "suffering patients, caring psychologists, dedicated clergy, devoted parents, hardworking police, concerned feminists and anxious communities". Together they shape the illnesses of the day that express and hide mental anguish.

For her version of reality, Ms Showalter has received death threats and a sackful of angry mail. If these illness are "all in the head", writes one ME sufferer, then the next time Ms Showalter needs a blood donation, ME patients "would be more than happy to share our blood with you, in more ways than one. Fortunately, the one thing you won't contract is 'hysteria'.

"We need," she says, "to restore confidence in serious psychotherapy". As an advocate of the "talking cure", she will be sympathetically received by many who have sampled the couch and felt better for it. We would not demur from the argument that the mind plays a part in conditions that until modernish times would have been thought purely physical.

But Showalter does not stop there. But surely she would accept that the mind's role too can easily be overstated and blind the diagnostician to non-mental causes. Explaining physical illnesses as psychosomatic has a far-from-perfect history.

In a famous study in the Sixties, Eliot Slater followed up 80 people who had had a diagnosis of hysteria at a neurology clinic. He found that a large number had subsequently developed real physical illness, such as epilepsy and multiple sclerosis, which, retrospectively, could be seen as the cause of the symptoms attributed to hysteria. Recently, the World Health Authority has dropped the term hysteria from its international classification of disease.

So, I asked Elaine Showalter if she had been overambitious in her hypothesis that none of these various phenomena was really rooted in physical causes. It is logically impossible to prove a negative, was she not confidently claiming to have proved the unproveable?

"It is true," she said, "that you cannot prove a negative. What you have to do is simply create a preponderance of evidence. Can you prove aliens don't exist? Of course you can't. You have to add up the evidence in the direction of the extraordinary unlikelihood and appeal to human reason. The burden of proof is on those who say aliens exist to prove their case, not on me to prove that they don't exist."

That's fine for the aliens issue. That's easy. But what of Gulf war syndrome, for example?

"What I am saying is that the scientific and political evidence for Gulf war syndrome is absolutely inconclusive and inadequate. The chemicals used in the Gulf cannot cause the symptoms that are being attached to them. There are scores of studies to show this. If you look at it logically, what is the alternative explanation to mine?"

There are quite a few, I suggest. Couldn't the governments involved have covered up the evidence? Couldn't Saddam Hussein have used a weapon of which we remain ignorant? In this light, doesn't her confident dismissal of other theories amount to irresponsibility? Wasn't it, I suggested, a dangerous risk to conclude that the only remaining possibility was true because the others had been eliminated? Indeed, hadn't she fallen into the same fundamentalism as those she criticised by speaking with such certainty about something that remained unproven?

Ms Showalter was unimpressed. "You are asking for open-ended speculation. Lots of things are conceivable. But at some point there has to be a strategic closure. At the moment we have 80,000 veterans complaining of these syndromes, terrified of publicity that is telling them they have a contagious disease that they are passing on to their wives and children. At what point do we say it is time to look very seriously at the psychological factors?"

But where I asked, was her conclusive evidence that psychological factors played an important role in all these issues? Why had she not included, for example, a chapter showing the effectiveness of modern psychiatry in resolving these issues?

"Because this is not a medical book. We are now at a level of debate, not proof. I'm not offering a cure." But she was suggesting a diagnosis. "Yes, and I think you can argue a diagnosis without the cure. You can argue diagnosis of Aids without the cure. You can prove that cancer is not caused by peanut butter or exposure to power lines without being able to show what will cure it. That is what I am trying to do. I am saying that satanic ritual abuse is not produced by groups of devil-worshippers sacrificing babies. That does not require me to show how you cure these people of this belief.

"The first step is to mount a substantial challenge to the material reality of these phenomena and see them collectively as social structures. Once that is done there has to be serious research on how to cure them more effectively."

She speaks with the conviction of the true believer who cleaves to a single system that explains everything - her diagnosis accounts for all conditions in the way that the holy water of Lourdes cures all maladies.

Can she really have such a closed mind? How would she feel, for example, if one day it was discovered that Gulf war syndrome really was caused by chemicals?

"That's a huge hypothesis. When I started doing this work, I would never have put myself on the line with an argument where I felt vulnerable to the day-to-day headlines. I'm convinced now that I'm right and have gone into print. That's why I don't pick up the paper every morning in a cold sweat thinking "Oh my God". But I'm not infallible. If I turn out to be wrong, so I'm wrong. Future generations will say this was a really stupid book. I'll take that chance"n

'Hystories', by Elaine Showalter, is published by Macmillan, price pounds 16.99.