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A uterus travelled to Le Roy — hysteria makes a comeback 03/12/2012

Posted by ALT in Children's Mental Health.
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Hysteria.   

In Greek it literally means “travelling womb,” because that’s what the Ancients thought caused all manner of feminine problems the label referred to — an errant uterus “floating” around inside the body, creating disturbances, taking up space.

"Ummm... uterus? You're hogging the couch."

 More recently, hysteria is (or once was) a medical term used to describe an overwhelming array of symptoms (including twitching, seizures, fainting, partial paralysis) experienced mostly by women, which are generally understood to be psychosomatic. 

It’s all in your head.

This label was the genesis of Freud’s psychoanalytic approach, and he originally got the idea from his teacher, the neurologist Jean Martin Charcot.  Charcot believed that many of his twitching, contorted patients suffered, not from any physical pathology, but from a traumatic psychological event which caused them to manifest psychosomatic symptoms.  It was unconscious symptom formation, or as Freud would term it, “repression.” 

There was a serious problem with all of this, however; every case listed by Charcot as an example of his theory would be understood today as a case of brain damage or epilepsy, not so-called “hysteria.” 

From this excellent essay on the history of “hysteria” by Robert Webster:

Many subtle neurological disorders, such as temporal lobe epilepsy, and frontal-lobe epilepsy, were unrecognised in Charcot’s day. At the same time, the internal pathology of head injuries remained an almost complete mystery. Closed head injuries, which produce concussion without leaving any external injury, were simply not recognised…

Arc-de-cercle, drawn by Gilles de la Tourette in his study of hysteria.

When Charcot was confronted by patients who adopted the arc-de-cercle position by compulsively arching themselves backwards, he was not to know that this posture (which is sometimes combined with rhythmic pelvic thrusting) was a characteristic manifestation of frontal lobe epilepsy. In fact this form of epilepsy would not be fully described until another hundred years had passed. Even temporal lobe epilepsy, with its bizarre hysterical-seeming symptoms, was not recognised until the 1930s or 1940s. Confronted by the symptoms of these medically uncharted conditions, Charcot had little option but to place them in the catch-all diagnostic category of an illness – ‘hysteria’ – for whose existence no reliable clinical evidence has ever been produced…

What made the resulting labyrinth of medical error all but inescapable was that practically every other physician had become lost within it. Over and over again, highly trained medical practitioners, confronted by some of the more subtle symptoms of epilepsy, head injury, cerebral tumours, multiple sclerosis, Parkinson’s disease, Tourette’s syndrome, autism, syphilis, encephalitis, torsion dystonia, viral hepatitis, reflux oesophagitis, hiatus hernia and hundreds of other common or uncommon conditions, would resolve their diagnostic uncertainty by enlarging the category of hysteria yet further. As a result medical misconceptions which sprang from one misdiagnosis would almost inevitably receive support, and apparent confirmation, from misdiagnoses made by other physicians. 

As you can see, “hysteria” essentially functioned as a catch-all diagnostic category when doctors were at a loss to explain symptoms [much like a few “modern” psychiatric labels I can think of].  As greater understanding of brain disorders has emerged over time, hysteria has been slowly winnowed away to nothing.  These days it’s an antiquated concept, one of the few examples of a psychiatric label was loudly defended as SCIENTIFIC! … and eventually abandoned, very quietly, as completely untenable, nonexistent.

Look who’s back in town

What happened to the girls in Le Roy” ran in Sunday’s New York Times Magazine, and it appears that what happened was mass hysteria, renamed “conversion disorder” for the purposes of public relations and modernity.  Or so we are lead to believe.

This is a pretty long article, so let me give you the bullet points:

* Starting about 6 months ago, 18 teenage girls in the town of Le Roy (in Western New York) successively came down with strange symptoms: tics, so-called “non-epileptic” seizures, flailing of arms and legs, etc. 

As you can see, this stuff is no joke:

Parents were individually told by doctors it was a “stress response,” but as more and more girls suffered they began to make connections.  Environmental toxins were suspected.

* Le Roy was an industrial town once host to flour mills, salt mines, (and slightly more recently), a large Jell-O factory.  One could “always tell what flavor the Jell-O factory was producing on a given day based on the color of the water in Oatka Creek.” 

Additionally, there are “natural gas wells on school property, toxic-waste cleanup sites within a few miles and a sticky orange substance oozing out of the playing fields.”  In 1970 a train accident in Le Roy dumped 10,000 + gallons of toxic chemicals including trichloroethylene (which has been proven to cause neurological damage), and currently fracking is a common practice in the area.  Put simply, there are a lot of environmental toxins to be concerned about in the area around Le Roy.

* Both the EPA [Environmental Protection Agency] and the NYSDH [New York State Department of Health] conducted tests for environmental toxins in the area and concluded nothing harmful was present in the air, water, or soil.  Independent (ie non-governmental) testers called in by concerned parents for a second opinion were barred at gunpoint by state police from collecting test samples.

* 5 months into the public health crisis, in January, officials announced their official opinion; it was conversion disorder.  These girls were “subconsciously converting stress into physical symptoms.”  They were suffering from mass hysteria.

Interestingly, this diagnosis was only announced AFTER a few girls and their parents made an appearance on the TODAY show to discuss their beliefs that environmental toxins might be the culprit – the very next day, in fact.

The author of the NYT article, Susan Dominus, goes to great lengths to have us believe that mass hysteria is the sole cause of these girls’ complaints.  She discusses turbulent family situations, traumatic pasts, social connections and alliances between them.  She is quick to discredit alternative diagnoses given by other doctors (such as Dr. Rosario Trifiletti, who suggested a newly emerging disease – PANDAS — which is an auto-immune disorder caused by an inappropriate response to strep infection and has been known to cause mental illness-like symptoms; more on that here), and marches out the EPA’s official findings of “no environmental toxins” at crucial moments in the narrative.

Probably in an attempt to pacify critics of the “conversion disorder” diagnosis, she repeats that it is a “real” disease – just because it is psychosomatic does not mean the girls are “faking it.”  We even get a little spoonful of brain science to prove the point.  (Something to do with lighty-britey brain scans, overactive amygdalas, etc.).

Some rather important points the author chooses to gloss over:

One of the girls closely followed in the story has been diagnosed with epilepsy — her mom was unconcerned while she convulsed on the floor on national television.  Another is reportedly taking 11 different pharmaceuticals.  One of the girls’ mothers has had a malignant tumor and a neurological condition called “trigeminal neuralgia.”  This woman has had surgery 13 times.  She also “suspects a cancer cluster on the street where she once lived in Le Roy — she and several of her neighbors have been stricken with tumors.”

That’s a lot of health problems for a small group of people!

Also:

At one point, reporters uncovered dozens of corroded barrels near the site of the aforementioned 1970 train wreck “oozing a putty-colored material” in an area labeled HAZARDOUS WASTE.  EPA officials quickly told reporters that they did not believe “for one second” that the barrels contained hazardous materials.  And what do you know… tests “proved” that they were totally safe.

Not for one second would I believe there’s hazardous waste in there!

You’ve got to be kidding me.

Most importantly of all:

There is at least one other girl suffering from the same symptoms who was NOT originally from Le Roy.  Lori Bronwell, a teen from Corinth, NY passed through the area last summer and soon came down with the same tics, twitchings, and spasms.  She was subsequently diagnosed with Lyme’s disease, and is currently being treated.  A press release from Dr. Trifiletti (the doctor who tested the girls for PANDAS) stated that two of the girls under her care also meet the Center for Disease Control diagnostic criteria for Lyme’s Disease.

Am I saying that all these girls have Lyme’s disease?  Of course not.  Am I saying it’s definitely environmental toxins?  No.

Here’s what I’m saying: I don’t know of, have NEVER heard of, a case of “conversion disorder”/hysteria that wasn’t really a case of a doctor reaching the end of his or her diagnostic rope (Freud included).  It is only too clear that levels of MANY neurological disorders and dis-eases — like autism, epilepsy, allergies — are rising and rising FAST.  These numbers simply can’t be explained away, not with claims of “under-diagnosis” in the past, and certainly not by telling those who suffer that it’s “all in their heads!”

We need to have a serious, public discussion about the very real consequences of toxic overload on our minds and bodies.  We need to keep searching for healthy and wholesome ways to live our lives, to heal ourselves and our world.

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