Although Charcot believed that hysteria was a disease of the mind, he showed little interest in understanding the psychological aspects. Psychological trauma may have been the catalyst for hysterical attacks, but Charcot believed that the nature of the trauma was not as important as the fact that the trauma had occurred (Evans, 34). He, therefore, rarely spoke with his patients. To Charcot, hysterics’ words were “vocalization, not communication,” and could not help him analyze the disease (Hustvedt, 188). Ultimately, Charcot’s end goal was scientific understand of hysteria, not psychological treatment.
He purposefully created space between himself and his patients not only because he did not see emotions as worthwhile, but also because he did not always trust his patients. According to Charcot, “a doctor who examine hysterics must always keep in mind that they want to fool him, to keep the truth from him, to tell him things that never happened, and to hide from him things that actually did occur” (Hustvedt, 36). Therefore, Charcot kept suspicious patients under constant monitoring, either by nurses or other female patients, who he referred to as the “best possible police” (Charcot, 194). He believed that this contributed to the low opinion of hysteria, because many saw hysterics as merely behaving that way for attention. He did, however, believe that even if patients were exaggerating real symptoms or creating imaginary ones, they still were suffering from the same neurological disorder. He believed that the doctors knew more about patients than the patients did about themselves, and this belief became a precursor to Freud’s ideas of psychoanalysis.
Charcot believed that although the symptoms were often persistent, hysteria was a treatable disease. However, he tended to focus on displaying and explaining the symptoms rather than relieving them. To Charcot, patients were “specimen types rather than individuals” (Furst, 117). He often, therefore, treated his patients during clinical lectures. The most common form of treatment during these lectures was hypnosis.
Charcot considered the hypnotic trance and hysterical attack to be “essentially equivalent phenomena” (Bernheimer, 7). Hypnosis, therefore, was the best way to gain access to the inner workings of the brain. He categorized phases of hypnosis just as he had phases of hysteria, into lethargy, catalepsy, and somnambulism (Hustvedt, 59). The problem with Charcot’s hypnotic methods was that he was most likely creating many of the hysterical symptoms. The medicines that he often gave before hypnosis created side effects resembling many hysterical symptoms. Patients developed addictions to the chloroform that he used to calm them for hypnosis, and withdrawal from this addiction could cause the convulsions and confusion associated with hysteria (Hustvedt, 46). The administration of chloroform also modified the symptoms and confused some of his data (Charcot, 196). Patients also became highly suggestible under hypnosis. Therefore, Charcot’s hysteria was in part an iatrogenic illness, or “one that was created in the clinic, forged between patient and doctor” (Hustvedt, 49). His dedication to hypnosis ultimately led to his discrediting in the neurological field, but his work with hypnosis brought him into contact with his most famous student, Sigmund Freud.