Books: Malaise at the millennium

Lisa Appignanesi on our aching hearts

Hystories: hysterical epidemics and modern culture by Elaine Showalter, Picador, pounds 16.99

Our turn of the century is plagued by diseases that are mysterious in origin and wildly eclectic in their symptoms. Recent headlines have focused on Gulf War Syndrome and ME, or chronic fatigue syndrome - apparently responsible for 51 per cent of long-term absence among schoolchildren. In this daring and provocative new book, Elaine Showalter asks whether there might be a common strand linking these enigmatic syndromes with the psychological plagues of recovered memory and multiple personality disorder, and with concurrent tales of alien abduction and ritual satanic abuse. Her short answer is yes.

Each, she argues, is a hysterical epidemic, whipped up in the media-infested crucible of our anxious fin de siecle. Each has a psychogenic core which, in our search for external solutions and magic-bullet cures, we are loathe to confront. Each is a "hystory" - a narrative of hysteria, spread by the virus of story, circulated through self-help books, newspapers, talk shows and e-mail. A literary critic, Showalter is also a historian of psychiatry, well versed in unpacking symptoms. She builds her case cogently, if swiftly, ransacking medical reports, film and fiction, press accounts and confessionals. There is an urgency to this book: the urgency of her worry for these blighted times, when every unhappiness needs a medical sanction.

Hysteria, that shifting and amorphous condition most often diagnosed in women, has a long and (dis)honourable history. In Hippocratic times, it was thought that the womb, hystera, travelled disobediently through the body and lodged itself in foot, bosom or throat to produce a dazzling array of symptoms: breathlessness and choking, tics and twitches, loss of voice, blindness, convulsions and sexual desires. With a dip into witchcraft and a sojourn in the nervous system, hysteria emerged triumphant, just over a century ago, in the Salpetriere clinic of Jean-Martin Charcot. His patients became star performers of acrobatic seizures on Paris's most fashionable stage.

Charcot understood hysteria to be a physical illness, occasioned by a hereditary defect or traumatic injury. With Freud, hysteria moved away from its organic base and was definitively lodged in the psyche. The unbudgeable tics and paralyses, coughs and limps, of Freud's early hysterics were seen as coded representations of repressed fantasies and anxieties. He set out to ease them, first by hypnosis and then by the talking cure.

With the First World War, hysteria underwent another transformation. Faced with the horrors of the trenches and the impossibly heroic ideals of masculinity, soldiers succumbed to blindness, muteness, tremors and paralyses with no organic base. Since hysteria was tainted by the feminine, the condition was re-dubbed "shell-shock".

The first part of the book engages in a history of hysteria to underline the fact that it is "a mimetic disorder". Distressed individuals can choose only culturally permissible ailments from their time's symptom pool. "An Englishman can legitimately complain of headache or fatigue, but not that his penis is retracting into his body - a perfectly acceptable symptom in Malaysia and South China".

We live in times of great stress and anxiety. They are also medically positivist times. A stigma is attached to any disturbance that cannot be found an immediate bacterial or environmental cause. A Gulf War veteran, suffering from a bewildering set of symptoms, can only feel humiliated if it is suggested his ailments are psychogenic. But Showalter forcefully argues that hysteria is a universal human capacity for converting emotional conflict and pain into culturally acceptable physical symptoms. It is a sign neither of weakness nor of madness. Only once this is acknowledged can we hope to avert the hysterical epidemics that plague us.

The most controversial aspect of this argument lies in placing Gulf War Syndrome and ME side by side with alien abduction or the recovered memory movement. In the latter conditions, Showalter also finds an insistence on a single, external cause of current pain: with alien abduction, the extraterrestrial who conducts experiments, often sexual, on the subject; with recovered memory, the experience of "real" abuse during childhood.

Showalter traces the common pattern in these disorders' progression from individual plight to culture-wide epidemic. She highlights the importance of the diagnostician or therapist's imprimatur and the manner in which vulnerable individuals will mimic symptoms of an available illness. Too often, disease scripts come from best-selling novels, mass-appeal films or confessional narratives. Their sameness is used to corroborate the existence of the illness in a spiral of self-reinforcement.

Showalter is a well-known American feminist. Hystories will enrage a great many of her sisters because of its attack on the recovered memory movement as a series of collusive confabulations between feminist therapists and their patients. Incest as trauma, she asserts, has ensnared the feminist agenda and infantilised women. Scapegoats, pursued from couch to court, are not a rational foundation for solidarity. She advocates the "courage to think" rather than the "courage to heal", as the title of a recent best-seller on recovered memory would have it.

Her mordant analysis of current "hystories" is tempered by reminders of the all-too-real violence against women and children in our society, as well as a recognition of individual suffering. Nor does Showalter fail to acknowledge that, in certain cases of Gulf War Syndrome or ME, there may be a triggering organic component. She certainly has the courage to think. Hystories is guaranteed to make us take a more reflective look at the fears and demons that so rampantly haunt our fin de siecle.