La invención de la histeria: Charcot y la iconografía fotográfica de la Salpêtrière

by Georges Didi-Huberman

Este libro narra y cuestiona las prácticas en torno a la histeria que se llevaron a cabo en la Salpêtrière en época de Charcot. A través de procedimientos clínicos y experimentales, por medio de la hipnosis y las "presentaciones" de enfermas en estado de crisis (las célebres "lecciones de los martes"), descubrimos una especie de teatralidad estupefaciente, excesiva, del cuerpo histérico. Este descubrimiento se realiza aquí a través de las imágenes fotográficas que han llegado hasta nosotros, las de las publicaciones de la «Iconographie photographique de la Salpêtrière».
Pero el análisis de estas imágenes también revela el acto de «escenificación» del que las histéricas fueron objeto por parte de los médicos. Charcot fue un "artista" de este género, pero ¿en qué sentido? Esto es precisamente lo que nos presenta esta obra.
Freud fue testigo de todos estos acontecimientos y su testimonio se convirtió en la confrontación de una aproximación totalmente novedosa de la histeria con ese «espectáculo» de la histeria que Charcot ponía en escena. Un testimonio que nos narra los inicios del psicoanálisis bajo la perspectiva del problema de la «imagen».

Genres: Photography, History, Art, Psychology, Nonfiction, Psychoanalysis, Science

427 pages, Paperback

First published January 1, 1982

About the author

Georges Didi-Huberman, a philosopher and art historian based in Paris, teaches at the École des Hautes Études en Sciences Sociales. Recipient of the 2015 Adorno Prize, he is the author of more than fifty books on the history and theory of images, including Invention of Hysteria: Charcot and the Photographic Iconography of the Salpêtrière (MIT Press), Bark (MIT Press), Images in Spite of All: Four Photographs from Auschwitz, and The Surviving Image: Phantoms of Time and Time of Phantoms: Aby Warburg's History of Art.

Reviews

[Eavan · Rating 4 out of 5]

This is a really difficult book to review because it holds pretty much everything available about the women of the Salpêtrière and the photographic methods in the English language. Huberman writes in a very flowery, disconnected way that is frustrating for academic contexts but rewarding when seen as poetic asides.

The women at the Salpêtrière are a fascinating look at what I call the epidemic of "mundane PTSD"—not of men coming back from war—but of women, predisposed by poverty and familial abuse, developing the same horrid cycles of trauma from physical or sexual assault. The agency in which these women attempted to have over their body (either from their literal inability to control it in fits to the male doctors orchestrating them) is fascinating and saddening.

I'd link my paper but it was so personal and already a relic of who I was only a month ago. Suffice to say, I would have been sent here—so here's to healing—and my absolute madwomen sisters <3

[Kat Pau · Rating 1 out of 5]

Tema muy interesante pero escrito de manera muy rebuscada.

[Tom Schulte · Rating 4 out of 5]

it amazes me to think that just a century and a quarter ago in France this was the cutting edge of medical science: staged theatrics photographed for sale while fantasizing on wandering, uncontrolled uteri. I wad drawn this fascinated by the fact that "hysteria" shares an etymology with "hysterectomy". The hysteric is under control of the disordered womb. Freud put Charcot, the conductor of this symphony of female mistreatment, on a pedestal, making pilgrimages for education, cocaine, and autopsies. This is a translation of a work originally in French and it feels as if the poetry and metaphor from the original is at times awkward and difficult in translation. While the on site photographic studio captured psychic aurae and seizures for sexualized description, Charcot's lectures featured dramatic demonstrations of triggered throes and coercion under hypnosis. The detailed story of one unfortunate inmate is that of Augustin, sexual victim turned star performer for special freedoms, really tells the whole story of women locked away and then subsumed into kaleidoscope of proto-psychiatric patriarchal fantasy.

[Angela · Rating 5 out of 5]

Estoy tremendamente enfadada por todo lo que se cuenta en este libro, pero me lo quiero tatuar en la frente de lo bueno que es.

[David Cebe · Rating 1 out of 5]

Un filósofo e historiador del arte se mete a juzgar con ojos del presente el pasado… desde el total desconocimiento de la historia de las neurociencias o la psiquiatría ¿qué puede salir mal?
Un libro de muy difícil lectura, muchos palos de ciego y escrito desde una superioridad moral insultante hacia personajes históricos que sabían mucho menos de lo que sabemos ahora.
Tiempo perdido

[samantha · Rating 4 out of 5]

Argument
• In the last few decades of the nineteenth century, the Salpêtrière was what it had always been: a kind of feminine inferno, a citta dolorosa confining four thousand incurable or mad women. It was a nightmare in the midst of Paris’s Belle Epoque. This is where Charcot rediscovered hysteria
• With Charcot we discover the capacity of the hysterical body, which is, in fact, prodigious. It is prodigious; it surpasses the imagination, surpasses “all hopes,” as they say.
• What still remains with us is the series of images of the Iconographie photographique de la Salpêtrière. It contains everything: poses, attacks, cries, “attitudes passionnelles,” “crucifixions,” “ecstasy,” and all the postures of delirium. If everything seems to be in these images, it is because photography was in the ideal position to crystallize the link between the fantasy of hysteria and the fantasy of knowledge.
• A reciprocity of charm was instituted between physicians, with their insatiable desire for images of Hysteria, and hysterics, who willingly participated and actually raised the stakes through their increasingly theatricalized bodies. In this way, hysteria in the clinic became the spectacle, the invention of hysteria
• Freud was the disoriented witness of the immensity of hysteria in camera and the manufacturing of images. His disorientation was not with- out bearing on the beginnings of psychoanalysis.
1. Outbreaks
• I am attempting, fundamentally, to reopen the question of what the word “spectacle” might have meant in the expression “the spectacle of pain.” It is an infernal question, I think, profoundly shrill and strident.
• Inventing can be understood in three different senses:
o Imagining
o Contriving
o inventing is finding or falling right on the shock of the thing, the “thing itself ”
• Pinel’s Salpêtrière was opened as an asylum in the mod- ern sense, whose first principle was the treatment of madness. A figure was even put to the curability of insanity; a science was emerging, a therapeutic science:“. . . there is a kind of probability, 0.93, that the treatment adopted at the Salpêtrière will be attended with success if the alienation is recent and has not been treated elsewhere.”
• Pinel did indeed deliver the madwomen of the Salpêtrière; he released them from total confinement, allowing them to coexist, notably through work. This opening up, however, was also an insertion: Pinel invented the asylum as a “little Government,”
• This hypocrisy as stage direction is what I will interrogate in Charcot: a strategic letting-be, a response that feigns to allow the word of the other to spin out at its own rhythm, but a response that is always al- ready interpretive, and thus oracular. It is hypocrisy as method, a ruse of theatrical reason as it presumes to invent truth.
• this method could not escape the figurative problem that obsessed every medical clinic, the problem of the link—the phantasmatic link—between seeing and knowing, seeing and suffering. How could all this passion be produced from figures of pain? This is the crucial phenomenological problem of approaching the body of the Other and of the intimacy of its pain. It is the political problem of the spectacular interest paid by the observed in return for the “hospitality” (the hospital’s capitalization) that he enjoys as a patient. It is the problem of the violence of seeing in its scientific pretensions to experimentation on the body. That this experimentation on bodies is performed so as to make some part of them—their essence—visible is beyond doubt. Why then presuppose that Charcot was constrained to the image, or to the imaginary?
• To return to our subject, something was constructed at the Salpêtrière, something resembling a great optical machine to decipher the invisible lineaments of a crystal: the great, territorial, experimental, magical machine of hysteria.
2. Clinical Knowledge
• The Salpêtrière was the mecca of the great confinement
• Charcot entered in 1862. Hysteria did not yet appear in the vocabulary.
• in this city of pain, Charcot was not only Sun King and Caesar, but also an apostle, who “reigned over his age and consoled it.”9 Charcot was also likened to Napoleon.
• But above all, with his “lovely pensive brow,” “somber visage,” “se- vere eyebrows,” “searching eyes, set deep in the shadow of their sockets,” “lips accustomed to silence,” “head carved after antiquity,”—above all, he was likened to Dante, the same Dante of the Descent into Hell.
• Charcot thus descended into hell; but he didn’t feel so badly there. Because the four or five thousand women of hell furnished him with material. the pleasant sensation of, quite simply, entering a museum. He himself put it quite well: it was a living museum of pathology, with its old “collection” and new “collection”
• He held courses on Fridays, lectures on Tuesdays. His evening re- ceptions on Tuesdays in his private mansion, 217 boulevard Saint-Germain, were of course attended by high society
• In the obituary he wrote for Charcot in 1893, Freud, strangely enough, compares him to the statue of Cuvier in Paris’s Jardin des Plantes (perhaps because Cuvier is petrified amidst the species to which he himself gave position and stature?). Freud then continues, in the logic of the strange, with another comparison: Charcot is like Adam, an Adam before whom God paraded nosological entities for him to name.
• Charcot did indeed rediscover hysteria (and in this respect his work is pioneering—but what, exactly, did it pioneer? This is the question). He named hysteria. He distinguished it from epilepsy in particular and from all other mental disorders. In short, he isolated hysteria as a pure nosological object.
• To know life, it must be vivisected. As for Charcot, he was faced with an even more daunting problem, for one cannot, one truly cannot get under the skin of a nervous patient to see how the illness works. Still less can one penetrate the “pathological life” of the cerebral convolutions of a deranged mind, without putting this life to death. Must one restrain oneself to observing without touching, and to merely observing the surface?
• Charcot has a gaze that observes and forbears, or rather feigns to forbear, from intervening. A mute gaze, without gesture. It feigns to be pure, to be the ideal of the “clinical gaze,” endowed only with a capacity to understand the language of the spectacle “offered” by pathological life. But can there be a spectacle without staging [mise en scène]?
• The accounts given by Souques and Meige suggest that Charcot could nearly forgo traditional questions like “What is the matter?” or “Where does it hurt?” For he seemed to have always already seen.
• How indeed can the actuality, or the present, of the symptom be defined? How can its catastrophic and thus singular appearance be staged? First, by instituting it as a case.
• The “case” serves as the clinic’s original “genre,”
• Classification configures the disorder and multiplicity of the case, making it into tables [tableaux].
• One must not forget that “cure” is nearly a founding word in psychiatry:54 cure is a care, concern, or treatment, but it is also a burden, direction, and thus a power; and it is precisely the effect of this power when conjugated with a med- ical concern, cleaning out from top to bottom (in the erotic language of the Romans, cura also designates an object of concern, curiosity, and cleaning: namely, the sex). There is perhaps no more essential indiscretion than such curiosity made into power.
o THE BURDEN OF CURE
o I would like to interrogate what, in the cure, and in curiosity, might be entailed by its more fundamental meaning as concern: cura, an anxiety. My question is: what anxiety bore within itself the compulsion, shared by Charcot and the Salpêtrière in general, to always “see something new”? What might have been its temporal stasis? And what was it—in the visible, in Charcot’s daily comings and goings—that might have profoundly demanded this stasis?
• And the fruit of its invention is an ethics of seeing. This is called, in the first place, the glance [coup d’oeil ], which also implicates the “fine sen- sibility” with which the clinical gaze identifies. It is an “exercise of the senses”—an exercise, the acting-out of seeing: glance, diagnosis, cure, prognosis. The clinical glance is already contact, simultaneously ideal and percussive. It is a stroke [trait] that goes directly to the body of the patient, almost palpating it.

3 Legends of Photography
• Charcot: But, truth to tell, in this I am nothing more than a photographer; I inscribe what I see.
• To the detractors and quibblers who reproached him for “cultivating” if not inventing hysteria at the Salpêtrière, Charcot thus retorts that, in the first place, it would be too fantastic and must therefore be false, a fiction (but we will see that what is fantastic exceeds fiction by realizing it, despite the fiction). Moreover, and above all, Charcot responds with a remarkable denial of theory, doubled with an allegation of “script”: an inscription-description (a fantasy of writing) understood as recording, the immediacy of recording: I inscribe what I see. ALLEGATION OF SCRIPT
• In this way, photography, for Charcot, was simultaneously an experimental procedure (a laboratory tool), a museological procedure (scientific archive), and a teaching procedure (a tool of transmission). In reality it was far more than this
• Photography procedes, first and foremost, from the graphic. More precisely, it is the development and supplement of the graphic
• The goal of Marey’s “graphic method” was to push aside the two “obstacles of science”: on the one hand, the mediacy of language (here practically reduced to a bare minimum), and on the other hand, the all too distracted and defective immediacy of “our senses.”
• The photograph thus produced a historic change in sight, such that “you cannot claim to have really seen something until you have photographed it.”
o photograph as “true retina”
• Before all these photographs, I always think, stupidly, about the anxiety the physician-photographer must have felt. (I recall—is it relevant?—the story of Jumelin, a famous anatomical modeler of the time. One day, he made a cast of a liver freshly extracted from a man suffering from “pox,” and, not in the least anxious and even a bit distracted, he happened to blow his nose on the cloth that had wrapped the organ to be “reproduced.” He, too, died of pox, a victim of his art and of some jovial refusal to be anxious about dissecting other people’s bodies, sick bodies.)
• If I thus speak of a veritable GORGE [engouement]* of photographs, it is to draw on the profoundly equivocal nature of the phrase, for the claim that psychiatry simply became besotted with photography would be correct, of course, but it does not account for the profound complexity of the phenomenon. Gorging oneself [s’engouer] with something signifies that you’re madly in love, and so you “stuff your face,” as they say, gobbling and swallowing until you can’t go on. And you suffocate from it: l’engouement is obstruction, strangling, from too much love.
• These images were, in fact, supposed to serve a memory. Or rather, the FANTASY of a memory—a memory that would be absolute, quite simply: in the moment of the shot, the photograph is absolutely immediate, “ex- act and sincere.”32 And it endures
Ch 4 A Thousand Forms, in None
• What men were chasing in hysteria was, above all, a bête noire; this is quite exactly how Freud described it, in French, in 1888
• Because hysteria represented a great fear for everyone, it was the bête noire of physicians for a very, very long time: for it was APORIA MADE INTO SYMPTOM
• It was the symptom, to put it crudely, of being a woman. And every- one still knows it. Ustéra: that which is all the way back, at the limit: the womb. The word “hysteria” appears for the first time in Hippocrates’ thirty-fifth aphorism, where it is said:“When a woman suffers from hys- teria or difficult labor an attack of sneezing is beneficial.”4 This means that sneezing puts the uterus in place, in its true place. This means that the uterus is endowed with the capacity of movement. This means that the woman’s sort of “member” is an animal.
• The bête noire was a secret and at the same time an excess. The bête noire was a dirty trick of feminine desire, its most shameful part. Paraclesus called hysteria chorea lasciva—the dance or choreography of lechery. Hys- teria almost never stopped calling the feminine guilty.
• Treating a hysteric?—Putting the animal-womb back in its proper place, meaning the lowest point.
• There were the convulsions, of course; overheated minds, recipro- cally pushing each other along, and the “nervous woman” would explode, jerked in all directions, in spasms, movements modestly called “irregular.” There were the vapors, of course; hysteria was distinguished by its “bilious-melancholic temperament,” plus something not quite right in the womb— but what? There were classifications, situating hysteria in the ranks of hysterias: the “venomous” woman, the “chlorotic,” the “menorrhagic,” the “feverish,” the “visceral,” the “libidinosa.” SYMPTOMS
• This is how an illness came to require definition by its seat. Localizing the essence of the ill
• And then he reopened the space that Charcot had spent so many years filling in. Charcot had forced hysteria to subjugate itself to the do- main of neuropathology. Because Freud listened, hysteria returned to rattle the epistemic bases of neuropathology. But Freud had had to pass through the great theater of hysteria at the Salpêtrière before beginning to listen, and before inventing psychoanalysis. The spectacle and its pain were necessary; first he had to get an eyeful.
• Of course, “hysteria in the male is not as rare as is thought,” and Charcot’s “polyclinics” were filled with hysterical men, like the famous case of a man by the name of Pin. This was Charcot’s great act of “courage,” his “discovery” of MASCULINE hysteria.
o It just so happens that the Iconographie photographique de la Salpêtrière, between 1875 and 1880, does not offer a single portrait of a man. Men did not enter the Salpêtrière as patients until June 21, 1881, when the “outpatient clinic was opened.” But it was not until 1888 that one could contemplate the photographed traits of a hysterical man.
o Even so, a tactic of sexual difference is implicated.

• Yet the Iconographie photographique de la Salpêtrière was, in a sense, a negation of tact, of contact.
• Tact became torture. Speculum—scalpel, cauterization. How dare I relate it to a dialectic of charm?
• Of course, the hysteric body is a great riddle of sensations.
• What Briquet called “perversions of sensibility”9 were in the first place, anesthesias: skin, muscle, bone, sense organs, “mucous membranes”10 and so on. Then, secondarily, were the hyperesthesias, or “hyperalgia,” ex- actly the opposite of anesthesia, but likewise appearing in all varieties and in all places:“dermalgia,”“myosalgia,”“cephalgia,”“epigastralgia,”“rachial- gia,” “pleuralgia,” “coelialgia,” “thoracalgia,” “myelosalgia,” “arthralgia,” “nevralgia,” “laryngo-bronchial hyperesthesia,” “pseudo-croupal suffoca- tion,” “hyperesthesia of the digestive track,” “nephralgia,” “cystalgia,” “hysteralgia.”11 Every organ of the hysterical body had its own pain.
• For the hysterical body in the asylum, it was the result of yielding to transference, consenting to the experiment. An automaton—now inert, now thrashing about, modelable in the end because called on, called on by a legend.
• The body was called on by caresses, even gropes, electroshocks, and penetration, delighting the morality of the toy, and constituting its works, styles, and feats.

[Nina · Rating 5 out of 5]

Quel livre intéressant et fascinant !

[Sunday · Rating 3 out of 5]

This could have been a brilliant read about the uneasy marriage between art, science and medicine. Unfortunately the writing style makes the process more difficult than enlightening. If you are up to the challenge there are some interesting snippets amidst the often disturbing imagery.

[Natalie · Rating 3 out of 5]

Painful. Fascinating subject matter, but the style is almost unreadable. Not sure if this is an issue of poor translation or if the original French is just as miserable.

[Mi.Yo · Rating 3 out of 5]

Es un libro muy interesante. No me convence mucho la forma en que está escrito y creo que deja aspectos importantes a tratar sobre la histeria ya que se centra más en la parte fotográfica. Sin embargo, rescata algunas cosas del psicoanálisis Freudiano.
Algo que destaco es el abordaje del tratamiento del cuerpo de las mujeres en los tratamientos y el cuestionamiento al rol médico.
Conclusión: Muy interesante aunque esperaba un poco más de aportes desde el psicoanálisis.

[Valentín Serrano García · Rating 4 out of 5]

Notable cruce ensayístico de, al menos, tres vertientes: (1) la antropología cultural, (2) la historia del arte (en su mejor tradición: Hegel, Nietzsche, Warburg, Belting...) y la (3) "psicología" cultural (psicoanálisis, fenomenología...).
Didi-Huberman logra demostrar hasta qué punto la estética es ética (Wittgenstein dixit), por qué la psicología es una práctica artística (para bien y para mal) y por qué la iconografía (y el arte) importan a la hora de decidir cómo curarnos de nuestra condición humana.

Independientemente de su carácter de rara avis (Didi-Huberman se desmarca, un tanto, de otros ensayos y, ciertamente, se sobre-excede en el estilo post-estructuralista), la obra es muy sugerente y permite atisbar los pliegues intrahistóricos más tremebundos. Es, pues, un ensayo histórico al mismo tiempo. Lamentablemente, es de esperar que el historiador al uso frunza el ceño al sentirse un tanto desorientado ante una obra a la par literaria, psiquiatrica, performática y filosófica.

Si no le pongo la máxima calificación es porque considero que, al contrario que en sus más arrebatados ensayos, Didi-Huberman es un tanto excesivo y retórico en el estilo. La obra podría ganar con un estilo más sencillo y una extensión más corta.

[Heather · Rating 3 out of 5]

3 stars for the content, the images, and the poetic prose. I want so badly to give this book 5 stars because there really is nothing like it, and because the content is so vast but so horrifically engaging. Also, because it touches on a period of time and events which I find is often skipped over and not spoken about. However, structurally speaking, this book is like a labyrinthe. I'm not sure whether some key things were lost in the translation process, but the way this book is laid out truly puzzled me. I felt like I was missing something important during the entire read. I'd like to know what that is, eventually. Still though, the photography alone is worth keeping this on my shelf.

[Victoria Olsen · Rating 3 out of 5]

I can see why there is a long list of people wanting To Read this book and very few who have Read or reviewed it. You have to be motivated to make it through the prose, even though it's a fascinating subject and the author is very knowledgeable. It's written in French High Academic style so be ready to wade through digressions and lots of references to theory that aren't explained. Nonetheless, the photographs are beautiful and I did find the text very thought-provoking. The author provides a rich context for the history of both photography and hysteria.

[Jacques le fataliste et son maître · Rating 4 out of 5]

Non sono in grado di recensire — forse anche gli eccessi di nebulosità nella prosa, che hanno offuscato la quinta stella, sono tali solo per me — ma posso testimoniare che è impressionante il viaggio nel mondo delle pazienti della Salpêtrière: misurate, tastate, sondate, legate, messe in posa ecc. — e altrettanto impressionante il mondo di immagini e desideri nelle teste dei loro medici.

[Donna · Rating 5 out of 5]

Amazing book. Photos are stunning.

[ava · Rating 4 out of 5]

danse perdue is exploring states of hysteria for performance in march.

[Hildegart · Rating 3 out of 5]

this is a good book that talks about Charcot and his work. Several pictures and photos are included.

[Helen]

Subtitled 'Charcot and the Photographic Iconography of the Salpêtrière', this book investigates the intimate connection between psychiatry and photography in the late nineteenth century. First published in 1982, for many years the book has been unavailable in English translation.

The author's lyrical writing - which at times resembles poetic prose - may be bewildering, even unpleasing, to readers who expect non-fiction writing to be crsip, efficient, and impersonal.

Added to that, Didi-Huberman assumes the reader knows the background details of Jean-Martin Charcot, an instructor at Salpêtrière, the Paris asylum for the insane and incurable. Charcot began working at Salpêtrière in 1862, his primary focus neurology. He believed that hysteria was a neurological disorder caused by hereditary problems in the nervous system. He realised that photography - still in its infancy - was a valuable medium to demonstrate the signs and symptoms of hysterical attacks, and hired professional photographers to take pictures of his patients (almost exclusively women) during the different stages of their attacks. Many of these photographs were published in a multi-volume work, 'Iconographie photographique de la Salpêtrière' (1877-1880). These photographs, Charcot believed, provided the 'proof' for his theories about hysterical attacks.

Didi-Huberman's book is lavishly illustrated with photographs, many of which feature Charcot's favourite, Augustine. At the age of fifteen, apparently after being raped by her mother's lover, she was admitted to Salpêtrière suffering from hysterical paralysis. She was also extremely photogenic.

The Salpêtrière photographs illustrate not hysteria, but the skewed relationship between patient and clinician. '[T]the physician made the attitudes passionnelles of 'his' hysteric into a masterpiece, the living image of a nosological* concept, and he practically glorified it, as an image.'

The patients who were photographed were awarded a special status, and were quite literally star performers. But Charcot did more than simply gaze - he used techniques including hypnotism, electric shock, and genital manipulation to trigger hysterical symptoms. As Didi-Huberman suggests, patients became essentially art objects, expected to perform, 'punished' (by being put back into a cell) if they did not. The author goes so far as to suggest that what the photographs represent is 'hatred made into art'. The physicians wanted the madwomen to stay mad - or at least aesthetically mad enough to produce good photographs. Augustine eventually relapsed. Perhaps she'd had enough of being the star turn. Disguised as a man, she escaped from the hospital. What happened to her afterwards is unknown - a Google search revealed nothing about her life post-Salpêtrière.

*nosology: the science of the classification of diseases
[January 2007]