Authors: Debbie Nathan
Cracking the literary world was slow going, however. At age twenty-three, Flora was still living with her parents and could not afford to move since she was giving her writing away practically for nothing. For obscure poetry magazines and fusty journals of belles lettres, she wrote about the poet Emily Dickinson’s fear of going outdoors, and about what nineteenth-century philosopher Henri Bergson would have thought of twentieth-century comedian Charlie Chaplin. She was paid for this work in copies of the magazines. She reviewed Broadway productions for a magazine read by college drama teachers and their students.
8
The job got her free tickets to plays, but it did not pay the rent.
“Money is God and controls the puppets in the Greek tragedy,” she wrote a friend in frustration. “But one does hope for some
deus ex machina
—out of the relentless machine, a saving god.”
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Her god would turn out to be Madison Avenue.
W
HEN SHE STARTED MEDICAL SCHOOL
during the height of the Great Depression, Connie Wilbur still felt humiliated by her failed athlete’s-foot soap, angry at being stifled as a chemist because of her gender, and weak from her long bout with thyroid disease. Barely a decade later, at the height of World War II, she was healthy, brash, and very busy. She had left chemistry for psychiatry, and she was a rising star. She had earned her medical degree by then and was working at a large hospital in Omaha that treated the mentally ill. There she specialized in helping patients who suffered from hysteria. She was considered so effective at this effort that her boss, a prominent neuropsychiatrist, once called in a camera team to produce a training film of young Dr. Wilbur in action.
Connie developed her ideas about how to treat hysteria during the 1930s, when she studied under a psychiatrist named Dr. Robert Dieterle, a professor at the University of Michigan medical school and a man of many talents. He had an operatic voice, fine taste in cars, and a penchant for hypnotizing people. Dieterle got his M.D. in 1923, and at first he practiced pathology; his specialty was cutting open the skulls of people who had gone mad before dying from syphilis.
1
He saw many syphilis sufferers in the hospitals—and other kinds of patients who exhibited extreme behaviors. Schizophrenics talked jumbles of nonsense, heard voices, and claimed to be Jesus Christ. Manics, who stayed awake for weeks on end
and dropped dead from exhaustion. Depressives, who sobbed and starved themselves.
In the early twentieth century, mentally ill people from rich families were kept in back rooms at home or sent to one of a handful of private, luxurious sanatoriums. The less affluent mentally ill—about a half million of them by the 1930s—were packed off to public mental hospitals, bedlams that housed thousands of patients apiece. Patients were often confined for years before becoming well enough to be discharged, and many never showed improvement. For psychiatrists, working in mental hospitals was a thankless job. They were poorly paid and looked down upon by other doctors. The patients they cared for, year in and year out, were a grey, disheartening lot.
One group, the hysterics, were different. For one thing, they didn’t spend all day, every day, doing nothing but scream, sob, stare, or rub their feces on walls. Certainly hysterics had disturbing conditions: blindness, legs that wouldn’t move, and numbness to pain, for instance. But they often exhibited what doctors called
la belle indifference
, a blithe unawareness that anything was the matter. Their cheeriness made them more pleasant to be around. Even better, most were young women—in a time when almost all psychiatrists were men. These patients were considered interesting to spend time with and fascinating to treat.
They were also considered neurotic, as opposed to psychotic. The difference, according to Sigmund Freud, was related to how the mind balanced the ego and the id. The id was the seat of the unconscious, where infantile, antisocial impulses roiled, especially those related to sex. The ego and superego were partly conscious, one sensible and pragmatic, the other constantly warning about evil, sin, and God. The anarchic id pushed against these higher structures. They usually pushed back smoothly, creating a balanced individual.
But if the ego was weak and the id broke through—or if the superego was too harshly tormenting—then psychosis developed, or its milder variant, neurosis. Neurotics were like overworked sentries who spent night after night guarding a palace without enough sleep. They were exhausted, anxious, and sad. Still, they managed to make a living—or their husbands did. Most neurotics shambled through life without ending up in public mental hospitals.
But hysterics’ behavior was at the extreme end of the neurotic spectrum,
and they were often institutionalized. Freud’s earliest fame had come from working with hysterics during the 1880s; all of them were women. He had first learned about hysterics a decade earlier, while studying with Jean-Martin Charcot, a French neurologist and the most celebrated medical man of the nineteenth century.
Charcot worked at La Salpetriere, an enormous hospital for indigent women in Paris. The ancient Egyptians and Greeks had developed their “wandering uterus” explanations for hysteria. Later the Vatican had taught that the disorder was caused by Devil possession. Charcot believed it was set off by brain lesions that some people were born with and which were activated when they suffered shocking experiences. No matter that he could not find the lesions when he performed autopsies on patients who died. Once a week he opened the Salpetriere to public shows of his doctoring. It was said that on the days of these exhibitions, traffic jammed the entire Left Bank as people—virtually all men—streamed to the hospital for a look.
Charcot led his hypnotized patients, most of them women, into a big amphitheater. Attempting to activate “psychophysiological pathways,” he pressed his fingers into their pelvises and under their breasts, and he screwed a leather and metal contraption above their ovaries. The women thrust their bellies upward, grabbed their throats, and swooned. Some even did a back bend, which Charcot named the “arc-en-cercle,” or circle arch. He photographed these artsy, libidinous movements, then bound the pictures into coffee-table-style books that he said illustrated the “laws” of hysteria. The books sold worldwide.
2
After a while suspicions developed that hysteria at the Salpetriere was mere theater, unconsciously acted out by suggestible women, and unconsciously created by Charcot himself. People started wondering why there was so much more of the disease in Paris than anywhere else in the world.
Despite this bit of skepticism, the late nineteenth century remained a golden age for hysteria. Doctors throughout the West latched onto the disorder, labeling it, as always, a women’s illness caused by the weak female system. It’s probably no coincidence that a modest rash of “double consciousness” or “multiple personality” cases—perhaps a dozen of them—emerged in Europe and America at this time, often among women already diagnosed as hysterics.
Many in the medical profession believed these women were defective,
just as hysterics were weak. But a neurologist named Pierre Janet disagreed. Working in France alongside Charcot, he came to believe that some children had a hard time dealing with traumatic events in their lives. Seeing something frightening, being sexually abused—such experiences could cause a little girl’s or boy’s mind to dissociate impressions of the terrible event. The dissociated memory would lie outside of consciousness but push against it, causing hysteria. In particularly stressful situations, the dissociated recollection might even erupt as a fully formed alternate self—a second personality.
The cure was to hypnotize patients and push them to remember the trauma which caused the splitting. People thus hypnotized often moaned, screamed, and shook as though they were reliving something horrible. This response was called “abreaction” and “catharsis.” Janet thought it was the only thing that could heal hysterics.
Freud was impressed with Janet’s theory of childhood trauma as the cause of hysteria. It made much more sense to him than Charcot’s idea of inherited brain lesions, and Freud suspected that the problem was usually sexual abuse. He began hypnotizing his hysteria patients and asking them over and over to verify his suspicions. Many denied being molested, but Freud refused to take no for an answer. Eventually, virtually all his patients “abreacted” memories of childhood sexual assaults by older relatives and nannies.
But some patients described impossibly bizarre scenarios during their relivings, including mass, Satanic rapes straight out of the medieval witch hunts. Freud was stunned by these phantasmagoric stories and did not believe they were true. Eventually he concluded that his patients were fantasizing. He stopped using hypnosis because he worried it was too easy for doctors to inadvertently encourage people to “remember” events that had not in fact happened.
Freud’s theory about the cause of hysteria began to evolve. No longer did he believe it was provoked solely by sexual abuse. Instead, he now said, the normal child had sexual impulses beginning in infancy, including Oedipus and Electra complexes—desires to possess their fathers and mothers. Children before adolescence successfully suppressed these fantasies, but during the sexual storms of puberty they could reactivate, creating conflicts and guilt feelings that were powerful but remained unconscious. Neurosis could result, including hysteria. The trick during therapy was to dredge up
repressed sexual memories and fantasies, using a technique Freud called “free association,” with the patient saying whatever came to mind. Often their utterances were not overtly sexual. But when Freud interpreted them, he always found sexual meanings.
Thus was born psychoanalysis, a theory about repressed childhood wanting, not forgotten childhood trauma. In this new context, patients with multiple personalities were nothing special, and neither were hysterics. They were simply people—mostly women—who badly needed to uncover their repressed childhood desires. Bring on the couch, and the talk.
With the rise of psychoanalysis, multiple personality theory died out as a mainstream psychiatric diagnosis. So did Charcot’s hysterical seizures and postures. For middle-class, urban women, fits, paralyses, deafness, and blindness became bemusing things of the past. It was as though hysteria were a fashion of clothing: first worn in Paris, then exported to citified Americans who eventually tired of it, and finally remaindered as a behavioral style for women in small towns and the countryside.
In the summer of 1933, Dr. Robert Dieterle—the Michigan psychoanalyst with the beautiful voice and the penchant for hypnotism—was working at the State Psychopathic Institute, a charity hospital in Ann Arbor. One day a dark-haired, fair-skinned sixteen-year-old girl was admitted. Her left arm was paralyzed for no physical reason, she couldn’t walk, and sometimes she went blind and lost her sense of taste and smell. She could be hypnotized very easily, and while in a trance she walked with no problem. But once on her feet she went deaf.
When Dieterle talked about his new hysteric to people outside the hospital, he called her by her initials, L.M., to conceal her identity. Just as Charcot had done fifty years earlier with his women patients in France, Dieterle started using L.M. as a teaching subject at the University of Michigan. He would hypnotize her and place her on display in front of the (mostly male) medical students. He was preparing L.M. for a demonstration one day in late October when she offhandedly remarked that she was only two years old. Dieterle was intrigued.
Several weeks after L.M.’s hypnotic declaration of toddlerhood, another teenaged hysteric, L.R., was admitted onto the ward. She was nineteen
years old. L.R.’s main problem, Dieterle decided, was “convulsive attacks in which her body arched.”
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He looked at Charcot’s old book of photographs from Paris, the one that showed the “circle arch,” and it looked a lot like L.R.’s posture. She also licked her lips, something else Dieterle had noticed in Charcot’s work (he called it “tongue eroticism”). Dieterle thought tongue eroticism looked babyish.
Once he noticed that L.R. was hypnotizing herself by staring at a light. He got the idea to put a baby bottle filled with milk into her mouth while she was in her trance. He did this several times, and on each repetition L.R. acted younger. It was as though she was changing from an adolescent into a newborn.
One day, while he was showing his students how L.R. liked to drink from baby bottles, Dieterle brought L.M. to the room and put her in bed with L.R. Until then, L.R. had been the only patient to get a bottle. But this time, Dieterle gave it to newcomer L.M. instead. Old-timer L.R. then went into convulsions until she got a bottle for herself. But when L.M. started whimpering that Dr. Dieterle—she called him “Dada”—“had a new girl,” L.R. responded by making strange, primitive sounds that the hospital staff swore were the cries of a newborn. Throughout the afternoon they plied L.R. with additional baby bottles. L.M. responded by sucking her thumb. L.R. sucked
her
thumb. L.M. wailed. Not to be outdone, L.R. peed in her pants, drenching herself from head to foot.
The doctors and nurses were in a tizzy at seeing adolescents acting like infants. Nurses clapped their hands to the chant of “patty cake.” Young male psychiatrists blew into the faces of attractive young female patients and yelled, “booh!” Someone came and took photographs, including at least one of L.R. in the throes of a trance. In the photograph, L.R. is wearing nothing but panties, her breasts completely exposed.
Dieterle also made a movie of L.M. and L.R. together. It features the young women on their backs with their bottles, kicking, stretching, and cooing when Dieterle’s colleague, a thirty-something, mustachioed psychiatrist named Edward Koch, walks by. Koch rocks the young women’s shared hospital bed up and down like a horsy ride. He jingles his keychain. And he sneakily tweaks L.R.’s right breast.