Smith Professor Helps Inform a Broadway Play
NORTHAMPTON, Mass. -- A Smith College professor recently provided historical context for a play that examines what was once a common treatment for hysteria in women, and which opened to rave reviews from the New York media last month.
The article, “Hysteria, Mysteria” by Helen Lefkowitz Horowitz, was published in the Lincoln Center Theater Review and offers insight into the latest comedy by Sarah Ruhl.
Set in the 1880s, Ruhl’s “In the Next Room, or the vibrator play” looks at the early days of electricity, when the vibrator was used by physicians to enhance a form of genital massage, which had been practiced for centuries as a treatment for hysteria.
In her article, Horowitz, whose book about the battles over sexual knowledge and suppression in the 19th century was a Pulitzer Prize finalist in 2003, traces the roots of hysteria as a female affliction and the treatments.
As a contributor to the Lincoln Center Theater Review, Horowitz, the Sydenham C. Parsons Professor, American Studies, attended the play's opening night at the Lyceum Theater in Manhattan.
In addition to Horowitz, contributors included such authors as Charlotte Perkins Gilman, who wrote The Yellow Wallpaper, and Annie Sprinkle, a prostitute and porn star who is now a sex educator.
Directed by Les Waters, the play will be performed at the Lyceum through Jan. 10, 2010.
"Hysteria, Mysteria" by Helen Lefkowitz Horowitz
Very early in Sarah Ruhl’s play we learn that Mrs. Daldry, a young wife, is seeking the help of a doctor for her case of the nerves. She weeps, and she mutters about the terrible dirty green curtains in her house that hold ghosts.
Her frightened words make me think of Charlotte Perkins Gilman’s harrowing and widely-read short story “The Yellow Wallpaper,” first published in 1892. In it the author imagined a disturbed young woman writing journal entries in a country house rented for the summer. She is confined to an upstairs nursery bedroom, wallpapered in a sulfurous yellow, a “smouldering unclean yellow.” Isolated from others, forbidden to write, and demeaned by her physician husband, she comes to see a woman trapped by the pattern in the wallpaper and, descending into madness, attempts to free her.
Mrs. Daldry is diagnosed as hysterical, as is the central character in “The Yellow Wallpaper.” As was Gilman herself when she went to Dr. S. Weir Mitchell in 1887 for treatment.
So what was hysteria? For a long time now, I’ve been trying to find out.
I first saw the word when, in reading about the lives of my favorite authors, I learned of the fate of some of the women in their families. Brilliant Alice James, the sister of Henry and William, spent most of her adult life as an invalid. Winifred Howells, the talented daughter of William Dean, entered Dr. Mitchell’s care in her mid-twenties, weighing only 58 pounds, and died in treatment. Clover Adams, the wife of Henry, committed suicide. And then there was Gilman herself. Why was it, I wondered, that daughters, full of vitality and promise as girls, seemed to self-destruct as they neared or reached adulthood? They experienced rapid mood-swings, heart palpitations, paralysis of their limbs, and numbness in parts of their bodies. Some became distraught and suicidal.
What was going on? This was a question addressed by a group of physicians who, calling themselves neurologists, rose up to treat women and men who seemed to suffer from hysteria or other nervous diseases in the decades after the Civil War. The wisest among them admitted that they really did not understand the sources of their patients’ symptoms. Mitchell, the most famous American physician treating female patients with the malady, wrote, “Hysteria is the nosological limbo of all unnamed female maladies. It were as well called mysteria for all its name teaches us of the host of morbid states which are crowded within its hazy boundaries.”
Essentially hysteria was a catch-all term for symptoms that could not be understood as resulting from any perceived somatic cause. Men suffered from it as well as women, but, given hysteria’s linguistic link to the womb, when it presented in men, physicians normally chose to call it hypochondria. From the early modern period, when medical writers had sought to distinguish mental illness from witchcraft, the disorder, whatever its name, had a grand career in Europe. A remarkable element of hysteria, as physicians came to understand it, was its variable and changeable quality. In the seventeenth century Thomas Sydenham wrote, “The frequency of hysteria is no less remarkable than the multiformity of the shapes which it puts on.”
It was the task of medical science in the late nineteenth century to find specific causes for specific diseases. The problem was that the tools at the neurologists’ disposal were inadequate to detect the specific causes of mental disorders, to register lesions believed to be on the brain or spinal cord. Nonetheless, medical practice was built on treating patients. The most important thing to understand about the neurologists’ approach to hysteria and hypochondria is that all of their treatments were centered in the body. In the most up-to-date understanding of the late nineteenth century, if the body could be healed, the mind would follow.
The neurologists saw many sufferers from hysteria in their practice. For example, the New York neurologist William Alexander Hammond reported in 1871 that in last six years he had seen 332 patients with hysteria, of whom all but three were females. From the writings of S. Weir Mitchell we get some of the clearest looks, for he made the treatment of women suffering from a range of mental symptoms his specialty. He advocated the rest cure, insisting on total bed rest, complete passivity on the part of the patient, no drugs, overfeeding, and massage.
In April 1887 Charlotte Perkins Gilman suffered a terrifying breakdown, what her era called “nervous prostration,” and she went to Dr. Mitchell for a month of his rest cure. Out of her experiences she wrote “The Yellow Wall-Paper.” I’m fascinated by Gilman, because she enables me to gain insight into what “hysteria” felt like in the era before Freud. The subject of my forthcoming book, Wild Unrest, her case of the nerves is both interesting and hopeful.
When Charlotte entered into Mitchell’s care, she was in her late twenties. She had been married for three years and had given birth to a child two years before. Her breakdown was not without warning. Since 1882 she had been suffering from bouts of what today we call depression. Although previously she had experienced grief and the “blues,” what made this first depressive episode distinctive was that in 1882 there was no seeming cause, no menstrual period, no personal loss. Suddenly, she simply felt numb. In writing of this to the man who was her lover and would become her husband, Charlotte wrote, “What ails me now I cannot say: I have lost my love as one loses a quotation familiar as the Lord’s Prayer—knowing it to be there, but unable to find it.”
The numbness would recur, as would times of being elated. As she moved closer to marriage, her depressive episodes deepened and became inextricably bound with her emotional and sexual relationship with Charles Walter Stetson. Before their May 1884 wedding, she found a certain acceptance of her variable state. As she wrote to a friend, “Well, I had rather be as I am, high and low, than mediocre always. The exaltation is worth the pain.”
Once she became pregnant, the balance shifted, and a new factor entered. What seemed like idiosyncrasy, was no longer hers to experience alone. For the first time she referred to herself as “hysterical,” but she used the word not to name disease, but to signify completely losing control. We can envision her as weeping loudly, perhaps with screams, rapid movements, beating her hands against anyone who attempted to constrain her or bring her out of it. Believing that an expectant mother must remain calm for the child she was carrying, a medical practitioner gave her bromides.
Charlotte greeted her daughter’s birth in March 1885 initially with joy, but then times of increasing despair set in. They came and went, but in her low moments she felt trapped, and, of course, she was bound by the needs of another. Under physicians’ care, she began taking a range of drugs, including compounds of alcohol laced with cocaine or morphine, packaged in medicinal bottles with such reassuring names as “Buckland’s Essence of Oats” or merely called “Coca.” She also tried escape, leaving her child of seven months in the care of her mother to live for five months with a female friend in California. All of these were temporary fixes.
As was the rest cure under Dr. Mitchell. Within two months after treatment, Charlotte was in as terrible a state as she had ever been. In deep distress, she sought freedom from home and marriage, this time with her daughter. She returned to writing, moved to California, separated from her husband, began to recover on her own. It was at this moment, in 1890, that she wrote “The Yellow Wall-Paper.” Over time, she found in writing, lecturing, and advocacy for women, important work. Her path-breaking Women and Economics remains a classic. Ultimately, with her second marriage, she also found satisfying love. Yet even with love and work, Charlotte continued to suffer for the rest of her life from episodes of depression—though, over time, they diminished in strength.
Gilman later came to believe that she suffered from “a good honest disease,” something she had to accept as part of herself. In 1887 it was called “hysteria”; today, “conversion disorder.” Essentially, however, it remains “mysteria.”