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Jean-Martin Charcot and the pathologisation of ecstasy

Extase_Iconographie-e1369328952903One of the things I want to argue in my next book is that ecstatic experiences have been pathologised in the secular west, to our detriment. People still experience ecstasy – by which I mean moments where we go beyond the self and feel connected to something bigger than us, usually a spirit but also sometimes another individual or group – but we lack the framework to make sense of such experiences. And, as Aldous Huxley said, ‘if you have these experiences, you keep your mouth shut for fear of being told to go to a psychoanalyst’ – or, in our day, a psychiatrist.

The medicalisation and pathologisation of ecstasy happened slowly over the last four centuries – it is a key shift in the emergence of secular society. Before the 17th century, if you had an ecstatic experience, you might either be canonized or demonized. Either way your experience was carefully defined and controlled by the Church, which has always been wary of unbridled ecstasy, particularly in women (see Monsignor Ronald Knox’s misogynistic Enthusiasm (1950) for a recent example – Knox writes ‘the history of enthusiasm is largely the history of female emancipation…and it is not a reassuring one’).

Then, from the 17th century on, cases of both ecstasy and possession were viewed not as spiritual encounters but as disorders of our mechanical body, the product of diseased nerves, or an over-heated brain, or ‘animal spirits’, or ‘the vapours’. In the 19th century, unstable women were increasingly diagnosed with ‘hysteria’, a disease which Egyptians suggested, back in 1900 BC, was caused by a ‘wandering womb’ (supposedly the womb could be lured back to its proper position by holding scented objects near the affected woman’s vagina).

220px-Jean-Martin_CharcotThe understanding of hysteria didn’t advance much in the 4000 years to 1856, when Charcot was made head of the Salpetriere hospital in Paris. Salpetriere was the biggest hospital for women in Europe, and a ‘grand asylum of human misery’, as Charcot put it. He and his team carried out ground-breaking research into several neurological conditions – Parkinson’s, Tourette’s, Multiple Sclerosis, Lou Gehrig’s syndrome – but it was his work on hysteria that made Charcot globally famous.

Hysteria was a notoriously loose and imprecise diagnosis, so Charcot attempted to classify it, and discover the physical cause of it. He insisted that hysterical fits followed four clearly-defined stages – 1) epileptoid fits, 2) ‘the period of contortions and grand movements’, 3) ‘passionate attitudes’, and 4) final delirium.

He claimed that, although hysteria was a physical disease caused by a lesion on the brain, one could artificially induce these four stages through hypnosis. To prove this, he used photography to capture the four stages of hysteria, and circulated the evidence through the Iconographie Photographique de la Salpetriere. Photography was still a new, somewhat magical science – rather like neuro-imaging today – and these photos ‘did much to fix the image of hysteria in the public mind’, according to the medical historian Andrew Scull.

Augustine vogue-ing in the Iconographie
Augustine vogue-ing in the Iconographie

Charcot also put on public displays, every Thursday, where he hypnotized female patients and provoked hysterical fits for the fascinated male public, which included everyone from Sigmund Freud to Emile Durkheim. Both in the photographs and in the public displays, Charcot had ‘star patients’ who were particularly good at performing the four stages of hysteria, including a pretty teenager called Augustine, and a devout woman called Genevieve.


These ladies expertly performed religious poses which Charcot’s team defined as ‘ecstasy’. And the team insisted that their work proved that all the religious ecstatics and demoniacs of yesteryear were suffering from hysteria. Joan of Arc, St Theresa, St Paul, Jesus himself were all evidently hysterics. By a happy coincidence, Genevieve – who suffered from particularly violent fits – came from Loudun, the scene of a mass demonic possession of nuns in the 17th century. Charcot had an extensive gallery of religious art, and displayed the drawings and photos of his hysterics next to this art – were they not one and the same condition?

An illustration of a fit of Genevieve's (right) next to an illustration by Rubens
An illustration of a fit of Genevieve’s (right) next to an illustration by Rubens

This equation of ecstasy with degenerative hysteria served a political purpose. Charcot and his disciples (particularly his main disciple, Desire-Magloire Bourneville) were closely affiliated with the Third Republic, which was virulently anti-monarchist and anti-clerical. Charcot and Bourneville were involved in the campaign to secularize medicine, and to replace nun-nurses with secular nurses. Each proof of the hysterical pathology of religious ecstasy was a broadside in this wider war.

Yet the irony, as several historians of hysteria have noted, is that in many ways the secular diagnosis of hysteria recalled the medieval Inquisition. Of course, none of the hysterics were burned – although they could be subject to physical punishments including mustard baths and ‘ovarian compression’. But they were made to follow and perform a cultural script defined and directed by a male power system, for the prurient consumption of a fascinated male public.

Again and again, the women would be made to perform hysteria, just as the poor nuns of Loudun were wheeled out, over and over, to go through their demonic antics. They would literally be fixed into poses, like ‘automatons’ or ‘statues’ as Charcot’s disciples put it, and then the poses were used as evidence for the pathology of ecstasy. This script advanced the career ambitions and political agenda of the men in charge, as it did in the Inquisition.

As with the Inquisition, it sounds like a form of pornographic cabaret masquerading as a public service. The Iconographie looks like a porn catalogue, with the photos of the sexy teenager Augustine interspersed with accounts of her sexual reveries. And the Thursday shows sound like something from the Moulin Rouge – the women are hypnotized by a gong or a tom-tom drum, the approach of the hysterical fit announced by the shaking of the feathers in their hats, before they fall to the floor clutching their vaginas as the male audience applaud.

Jane_Avril_by_Toulouse-LautrecIndeed, one of the star-hysterics of the Salpetriere went on to become Jane Avril, a lead-dancer at the Moulin Rouge who was painted by Toulouse-Latrec. She claimed she was cured when she learned to dance, which goes back to the ancient Greek idea that the best cure for anxiety and phobia, particularly in women, is the ‘Dionysiac cure’ of dancing. Augustine, meanwhile, finally escaped from Salpetriere, dressed as a man, while Genevieve was offended one day by Charcot and refused to be hypnotized anymore.

Was this the diagnosis of hysteria or, as Charcot’s critics insisted, its cultivation? Was this merely an ‘absurd farce’? It didn’t help that something like 500 hypnosis vaudeville shows sprang up around Paris in the 1880s, some featuring women fresh from their debut at the Salpetriere.

Charcot’s search for a materialist cause for hysteria ultimately failed, and the consensus grew that his fantastic shows were merely the result of suggestion. But a few in the audience – including Sigmund Freud and Frederick Myers – still thought he had hit on something important.

If nothing else, Charcot’s use of hypnosis showed the profound connection between mind and body – his hypnotized patients felt no pain, and their physical symptoms could sometimes be cured by hypnosis and suggestion. His work suggested the existence of what Myers called a ‘subliminal self’, which could be brought to the surface under hypnosis. And it suggested a connection between spirituality, sexuality and subliminal or hypnotic states.

However, Charcot – and, later, Freud – defined hysteria purely as a symptom of female sexual disorder, when it could be argued it was just as much a product of male sexual disorder. Many of the hysterics had been raped as children or teenagers, and were struggling in a society dominated by men with few opportunities for female liberty. Performing sexual hysteria for a titillated male public was one opportunity for approval, expression and a sort of fame.

Frederick Myers, founder of the Society of Psychical Research and gifted writer on psychology (alas all his works are now out-of-print)
Frederick Myers, founder of the Society of Psychical Research and gifted writer on psychology (alas all his works are now out-of-print)

Frederick Myers and William James, meanwhile, accepted the idea that spirituality might be connected to sexuality, to hypnotic or subliminal states, and to nervous instability. But they insisted it wasn’t necessarily pathological or degenerative – many of the geniuses of human culture were ecstatics, much of our culture is the product of ecstasy. Perhaps, wrote Myers, ‘ecstasy is to hysteria somewhat as genius is to insanity’.

In fact, as Asti Hustvedt argues in her excellent Medical Muses: Hysteria in 19th Century Paris, in seeking to pathologize ecstasy, Charcot ended up spiritualizing medicine. He used the language of religion – ecstasy, stigmata, possession – and also some of the ritual and performance of religion. He and his disciples explored how hypnotized women seemed to exhibit miraculous powers of telepathy (a word Myers later coined).

By the end of his career, Charcot, like William James, came to recognize that religious ritual could be powerfully healing, even if the mechanism that healed was really ‘just’ suggestion. His last work, an article on ‘the faith cure’, suggests the miracle cures at Lourdes and elsewhere are real, but simply the result of suggestion. James and Myers went further, speculating that the hypnotized self might also be more open to spiritual forces.

We still don’t know. Hustvedt notes that, while ‘the hysterics of yesteryear’ have disappeared, a new batch of poorly-understood and possibly psychosomatic illnesses have proliferated – chronic fatigue syndrome, ME, post-viral fatigue, cutting, anorexia, conversion disorder, depression, psychogenic non-epileptic seizures, mass psychogenic illness – the prevalence of which is higher, sometimes much higher, in women than in men.

Are these real or invented? Physical or mental? Pathological or spiritual or both? We still don’t know. We don’t yet understand the relationship between mind and body, between mind and gender, between your mind and my mind, and between our minds and nature / God / Super-consciousness.

One last item in this bizarre and fascinating history: the vibrator was invented in the late 19th century as a result of the ancient theory that female orgasm (or ‘paroxysms’) helped to cure hysteria. Doctors would bring patients to paroxysm by manipulation, but complained their hands got cramp, so one bright spark invented an electric dildo. Meanwhile the first electrically-vibrating bed was actually developed as part of an 18th-century sexual-religious-health show called the Temple of Health and Hymen – where the star-performer was the delectable Emma Hamilton.

Don’t you think this would all make a brilliant musical?

The Shining: Kubrick’s unheimliche manoeuvre

How do you…fill your days?’
My editor was looking at me with a hint of concern, in a cafe on Portland Street. She was worried I was losing my edge. It had been almost a year since my first book had come out, and still I hadn’t started working on another. Well, I thought to myself. Kubrick didn’t rush his projects. 12 years between his penultimate and final movie. Besides, how could I explain to her or anyone that I’d spent the last four days somewhere else entirely, perhaps in another dimension, also known as the Overlook Hotel.

But I’m getting ahead of myself. It all started on Tuesday.

On Tuesday evening, I watched a film called Room 237. It introduces us to some of the online obsessives who, in the last few years, have put forward complex and often very sophisticated readings of Kubrick’s horror-masterpiece of 1980, The Shining. We hear from six critics, each putting forward a different master-theory of the film: that it’s about the Indian genocide, or the Jewish holocaust, or the faking of the moon landing. Some of the theories are more credible than others, but the film certainly convinces you that Kubrick is playing some strange semantic games.

There’s the question, for example, of whether the ghosts in the hotel are real or just a reflection of Jack’s inner demons. He only ever sees the ghosts when there are mirrors around. Who is the management of the hotel, the higher powers driving him to kill his wife and child? There’s also the weird ending, with the photo of Jack from a party at the hotel in 1921. He is told that he’s ‘always’ been the caretaker. Has he been reincarnated? And who in damnation is that guy in the bear suit?

Then there are the little details that have driven online theorists crazy with speculation. The film is full of continuity errors – furniture appearing then disappearing, photos on the wall changing arrangements. The first scene in the hotel takes place in a room which appears to have an impossible window (see the map below) – as if the hotel’s architecture doesn’t make sense, like a building in a dream. These hints of hidden meanings and codes have driven people to construct theories bringing together every single detail in the film, from typos on the pages Jack writes (‘all work and no play makes Jack a dull boy’) to the cartoon figures on Danny’s bedroom door. Everything becomes soaked with hidden significance.

Re-activating Animism

One way to understand the film is as an exploration of how we have an emotional need to find hidden meanings, as Sigmund Freud discussed in his essay, Das Unheimliche, or The Uncanny. Kubrick and his co-writer Diane Johnson repeatedly read and discussed this essay while writing the script for The Shining.

In his essay, Freud begins by exploring the etymology of the German word unheimliche, the opposite of heimliche which means ‘homely’ or ‘familiar’. He suggests that the uncanny is the fear we feel when the homely is made strange and frightening to us. Freud then explores some of the plot-devices with which Gothic writers produce this feeling in us  – ghosts, dopplegangers, telepathy, curses, apparitions in mirrors, inanimate objects coming to life, events from the past repeated, numbers repeated, symbols and patterns repeated, all of which produce the over-riding sense of “something fateful and unescapable”. Freud suggests that these Gothic plot-devices work on us emotionally because they reconnect us to our pre-modern animist beliefs. The uncanny, he writes, connects us to

the old animistic conception of the universe, which was characterized by the idea that the world was peopled by the spirits of human beings, and by the narcissistic over-estimation of subjective mental processes (such as the belief in the omnipotence of thoughts…the carefully proportioned distribution of magical powers)…It would seem as though each one of us has been through a phase of individual development corresponding to that animistic stage of primitive man, that none of us has traversed it without preserving certain traces which can be re-activated.

Romantic literature attempted to keep alive this old animist paradigm within the scientific-industrial age, and succeeded for a while, but gradually such beliefs came to seem more and more childish to us, and were pushed to the margins of our culture, into nursery rhymes and fairy tales, and then into the ‘low art’ of fantasy, horror, science fiction and comic book culture. Modern men and women duck into the low dives of ‘trash culture’ to re-activate their primitive belief in the spirit-world.

Kubrick recognised this cultural-religious function in sci-fi (he explored animist-religious ideas in 2001: Space Odyssey) and in horror-fantasy. He rang up Stephen King at 7am one morning, in their first conversation, and launched in with ‘I think stories of the supernatural are always optimistic, don’t you?’ King, perplexed, asked ‘why do you think that?’ ‘Because supernatural stories all posit the basic suggestion that we survive death.’ They appeal, he later said, to our ‘longing for immortality’. They also posit the suggestion that there is some higher pattern, some secret dimension, to our banal material existence, which is also perhaps an optimistic idea, even if the secret dimension turns out to be Evil.

Engineering the Uncanny

What Kubrick does in The Shining, and what David Lynch does in his works, is masterfully re-activate these animistic traces and engineer a sense of the uncanny. (Kubrick made the crew watch Lynch’s Eraserhead before making The Shining to give a sense of the mood he wanted to evoke, while Lynch’s Twin Peaks is clearly influenced in turn by The Shining). Take Kubrick’s repetition of certain numbers. Freud noted:

we of course attach no importance to the event when we give up a coat and get a cloakroom ticket with the number, say, 62; or when we find that our cabin on board ship is numbered 62. But the impression is altered…if we come across the number 62 several times in a single day, or if we begin to notice that everything which has a number – addresses, hotel-rooms, compartments in railway-trains – always has the same one, or one which at least contains the same figures. We do feel this to be ‘uncanny’, and unless a man is utterly hardened and proof against the lure of superstition he will be tempted to ascribe a secret meaning to this obstinate recurrence of a number…

Kubrick seized on this idea for The Shining. The cover of his edition of Stephen King’s novel is covered with scrawls of him trying to work out ways to use the number 217, which in King’s novel is the hotel-room where Danny and Jack see a witch (it’s changed to the number 237 in the film).

Kubrick’s copy of Stephen King’s The Shining

Kubrick repeats the number 42 throughout the film – on Danny’s shirt, on the number-plate of Hallorann’s car. When Danny and his mum are watching TV, it’s showing a film called The Summer of 42. The numbers 2, 3 and 7 when multiplied together make 42. The stools in the bar where Jack meets the ghostly barman are arranged in a group of four and a group of two. And so on.

Kubrick also plays with mirrors, twins, dopplegangers and doubling to suggest hidden connections between figures – Danny is connected by telepathy to Hallorann, Jack is haunted by the ghost of the previous caretaker Grady, or maybe he is the previous caretaker. David Lynch did the same sort of thing in Twin Peaks – Laura is doubled with her evil doppleganger from the Red Room, and also with her cousin Maddy. Her father Leland is also Bob, who appears when he looks in mirrors. In the Red Room, the giant is doubled with the dwarf, who speaks in reverse in a sort of mirror-language, just as Danny does when he chants Red Rum. Both Kubrick and Lynch also use garish carpet patterns to suggest hidden patterns in reality (they should have opened a store together: Uncanny Carpets).






The Uncertainty of the Uncanny

At the heart of the uncanny is a confusion of the self and its boundaries. The philosopher Charles Taylor suggests that in the modern secular age we all have ‘buffered selves’ that are walled off from nature and from each other. In the animistic age, we had ‘porous selves’, selves without firm boundaries, invisibly connected to each other by thoughts, energies, elective affinities, and also connected to the spirit-world, capable of being invaded by  benevolent or malevolent spirits. In the modern world, we are autonomous agents trying to figure out what to do in an indifferent universe. In the animist world, we are the creatures of the Fates, threads in some cosmic pattern of Good and Evil.

The uncanny is a particularly modern emotion, however, because it rests on an ambiguity and uncertainty about whether there is a natural or a supernatural explanation for the eeriness of the atmosphere. The Bible is not an uncanny work because it is very clear that all the supernatural events are the work of God or the Devil. There is no ambiguity. The Shining is an uncanny work because there is this uncertainty. This is what initially drew Kubrick to King’s novel. The ghosts appear at the corner of our eye, at the margins of our modern rational consciousness.  The events in the Overlook Hotel could be explained in secular Freudian terms as fantasies emanating from the hidden violence in the Torrance family – Jack’s murderous anger and Danny’s Oedipal rage. The Shining could simply be a story of male domestic violence against women and children. Likewise, Twin Peaks could simply be a drama about an incestuous family.

Kubrick complicates matters further by introducing a political level of significance. The violence in the film could also point to the historical violence of white Americans against Indians (the hotel is on an Indian burial-ground and there are Indian symbols around the hotel) or African slaves, or the Nazis against the Jews (42 was the year Hitler began the Genocide). Or the film could simply be a story of how the political elite (the hotel management and its powerful guests) use stooges like Jack for their state-sponsored mass murders – look, in the final photo, how Jack’s hand seems to be held up by the rich people around him. He is their  puppet, their errand-boy.

Can we escape the past?

Is The Shining really an optimistic film, as Kubrick suggested all horror stories are? On one reading, the film could suggest humans are trapped in cycles of violence, frozen in sin like Jack at the end of the film,  doomed to repeat our crimes over and over. On the other hand, Danny and his mother escape the Overlook Hotel. Danny is not lost in the maze – he retraces his steps and gets out. Perhaps we too can escape history.

Perhaps the film suggests that we’re at risk when we overlook things, when we forget the crimes of the past – like Dilbert Grady apparently forgetting that he killed his wife and children. Art holds a mirror up and show us our dark side, reminding us to take care, showing us a way out of the maze like Ariadne’s thread or Perseus’ mirror-shield.  Kubrick said: “There’s something inherently wrong with the human personality. There’s an evil side to it. One of the things that horror stories can do is to show us the archetypes of the unconscious: we can see the dark side without having to confront it directly.”

Or perhaps that is too neat and utilitarian an explanation of art’s power, and art is in fact more dangerous than that. The uncanny, after all, is a dangerous emotion. Once activated, how can we be sure it will stay within the bounds of art and not spill out into reality? How can we be sure we will not ourselves be possessed by the old belief-system and find ourselves back in the demon-haunted world we thought we had left behind?

Kubrick wrote: “Freud said that the uncanny is the only feeling which is more powerfully experienced in art than in life. If [horror] required any justification, I should think this alone would serve as its credentials.”  For better or for worse, we crave the uncanny. We have a deep emotional need for patterns of meaning and intimations of immortality. Freud would say that was the vestige of our primitive self, Jung would say it was our true self seeking its Maker.

Either way, modern life does not that satisfy this emotional need for the uncanny, so we turn to art, and to The Shining. We try to decipher Kubrick’s intentions as if he was God, and every detail of His creation is a clue to His meaning. Like lost souls, the acolytes haunt the Kubrick archives at the University of Arts London, which I imagine as a vast warehouse containing an almost infinite number of crates. And in one of those crates, perhaps, lies the key.


In other news:

John Gray is our next guest at the London Philosophy Club, on April 9. You can sign up here.

How useful would randomised controlled trials be in public policy, in areas like education for example? The debate rages on the internet, as Michael Gove dismisses ‘bad academics’ for blocking evidence-based policies, while some academics suggesting there are risks to thinking everything can be quickly solved by an RCT. Rebekah Higgit summaries the debate and provides lots of useful links here, while Evgeny Morozov warns of the risk of ‘solutionism’ in public policy, in his new book reviewed here.

Teenagers used to define themselves by whether they liked Blur or Oasis. Now they define themselves by whether they own Mac or Samsung, argues this piece. And, to prove how chic geekdom has become, Owen Wilson and Vince Vaughn’s new film sees them become hapless interns at Google. Sounds…pretty dire!

I’m working on an article looking at five years of Improved Access for Psychological Therapies (IAPT), the British government’s flagship mental health policy which has brought CBT to the masses. Here is a good blog by a therapist looking at the data coming out of IAPT. And here’s a good new article in Philosophy, Psychiatry and Psychology looking at the limits of evidence-based medicine in psychiatry (behind a pay wall alas).

A philosopher and psychologist debated whether psychology was a science or an art on Radio 3’s Nightwaves this week. The debate then rumbled on for days on Twitter…for all I know it’s still going. The discussion is 34 minutes in here.

Some new books. My friend Tom Chatfield from the School of Life has a new book out called Netymology, a dictionary for tech language. Another friend, Tom Butler-Bowden, has a new book out called 50 Philosophy Classics – I’ll publish an interview with him soon. I’m still reading David Esterly’s book about wood-carving and philosophy  – it’s really brilliant. I admire David a great deal.

Finally, here’s a Tumblr that made me laugh a lot this week – a collection of lousy book covers from the world of fantasy fiction. Enjoy, and see you next week.