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On Pithiatism
On Pythiatism Jean Paul Sartre was so inordinately obsessed with Gustav Flaubert that he just had to write a multi-volumn psychoanalysis of Madame Bovary's author - The Family Idiot. Flaubert was not the idiot Sartre supposed him to be. Sartre's description and cutting analysis of the French literary realist's life is more of a subjective autobiographical projection than an objective biography. Sartre proves himself to be a neurotic while arguing that Flaubert is neurotic. Sartre's approach is neither disinterested nor sympathetic, but is rather prejudicial, vindictive, and ideological (Marxist). Sartre will not let up. He gives Flaubert little credit, and uses him to prove his own preconception, that society is sick, and that Flaubert is its sick representative. Nonetheless, there is more than a grain of truth in what amounts to Sartre's representation of his own time; which is, in turn, more or less a development of Flaubert's time. When we speak much about a certain person, we often talk a lot about ourselves at the same time. Indeed, yours truly is somewhat obsessed with Flaubert. Sartre presents Flaubert as a neurotic whose neurosis is a monastery to which he withdraws, from reality, to live an imaginary life as a novel writer. Flaubert's Imaginary is not, like life, dynamic, but is static in defense, is immutable, fixed. His Imaginary is style, pure style. He keeps his muse, Louise Colet, at arm's length in Paris and writes to her from his sanctuary near Rouen, advising her at a distance to think only of style. But pure style is the formless form of Nothing. Flaubert is engaged in an aimless subjective activity which is ultimately inactivity, or passivity. That preoccupation, according to Sartre, is onanistic, mental masturbation. The rigid response to the environment is an end in itself. However, Sartre holds that Flaubert's ejaculations - his work - is not pathological - it is neurotic. He insists that Flaubert's "morbid passivity and pithiatism made him choose the Imaginary as a permanent milieu against the Real." His "directed dream," then, is tantamount to a continuous annihilation of Being; his choice of the Imaginary is a "break" or "rupture" from the Real. Thus he regresses to the preneurotic stage prior to his crisis - a sort of epileptic fit he suffered as a young man - to realize in the relived crisis the theme of his neurosis. Hysteria is Dr. Sartre's diagnosis, not the vulgar, convulsive, rigid hysteria, but a facile, evasive hysteria. Wherefore Art is Flaubert's excuse not to live the dynamic life he is afraid of. Sartre's ideological prejudices presume the social determination of the hysteria. Flaubert is a unique universal-singular or concrete-universal totalizing his sick bourgeois class with his self-centered, categorical individualism. And that is why his work happens to be popular - like all best-selling authors, he affirms his class - neurotic authors succeed in neurotic societies. Of course from the bourgeois perspective, to be "sane" is to be bourgeois. According to Sartre's Marxist class-conflict ideology favoring the rise of the downtrodden proletariat, to be popular is to be false. In any case, Dr. Sartre's piercing analysis is even more ruthless than the surgical realism he attributes to his analysand - Flaubert the positivist is a doctor's son, a childhood witness, in the hospital where the Flauberts lived, to several remarkable autopsies. Sartre employs an unusual term for hysteria - pithiatism - and we wonder what it means. We might find it defined somewhere as "luciferous logolepsy" - an obsession with words, and suppose that might amount to verbal hysteria. The term "pythia" reminds us of the possibly drug-induced oracular ranting of the pythias - an order of Cretan nuns - at Delphi in response to questions put to the oracle. The ravings were ambiguously 'interpreted' by male priests, in bad verse, sometimes in accordance with arrangements already made by the priests with the party by who asked the question - hence the fix was in and the temple was paid for. The mutterings may or may not have been the result of suggestions made to the prophetess before she drank the spring water, chewed the laurel leaves, and inhaled the gas from the chasm. The interpretations rendered by the priests, if not arranged for in advance, were ambiguous enough to depend on the subjective disposition of the party concerned, who would no doubt do what he wanted to do in the first place, but seemingly with divine sanction. If the outcome was against him, it was then no fault of the oracle or of the interpreting priest, for it could be demonstrated that the seeker had misconstrued the verse, and that some other meaning more appropriate to the outcome appertained. In any event, the oracle at Delphi was persuasive enough to provide confused people with self-confidence enough to take the course of action they consciously or unconsciously desired to take before seeking counsel. Turning to the Oxford Unabridged Dictionary of the English Language, we find the following definition: Psychol. Pythiatism. a. pithiatic. A type of hysteria thought to be amenable to and curable by suggestion. 1910 Lippincott's New Med. Dict. 740/2 Pithiatism, = Hysteria. (Babinski.) Ibid., Pithiatic. 1913 E. JONES in White Jelliffe Mod. Treatm. Nervous Mental Dis. I. viii. 370 Babinski attempts to divide verbal suggestions into those that are unreasonable..and those that are reasonable and beneficial... Treatment by means of persuasion he calls ‘pithiatism’. 1918 J. D. ROLLESTON tr. Babinski's Hysteria or Pithiatism p. xv, Among the various nervous phenomena observed in the neurology of war it is most important to distinguish hysterical or pithiatic disorders. 1930 P. D. KERRISON Dis. of Ear (ed. 4) xxii. 551 Pithiatism implies not only the possibility of cure by persuasion, but also the fact that the disorder may in some degree be called into being by suggestion. Ibid., Pithiatic deafness... is at its inception a veritable deafness, the inevitable sequence of a shock to the perceptive labyrinth, which could have had no other result. 1975 Y. PELICIER in J. G. Howells World Hist. Psychiatry iv. 131 Babinski (1901) proposed the name of ‘pithiatism’ to designate a special condition, where suggestion is able to produce or suppress clinical symptoms. We find that the term 'pythiatism' is variously employed in reference to both the hysterical 'disease' and to its cure. As verbal hysteria, it may be defined as a flexible and open-ended verbal break with reality without physical spasms. Of course hysteria is no longer included in most scientific nosology. Hysteria in common parlance connotes a strategic break with the reality of the social situation; for instance, the woman who resorts to hysterical behavior instead of a direct violent confrontation with an overpowering force. Here is something pertinent from Ilza Veith's HYSTERIA, THE HISTORY OF A DISEASE, Chicago: University of Chicago, 1965: "Babinsky's great number of publications on hysteria beginning in the early nineties of the past century had made him an authority on the subject. Soon after the outbreak of the First World War, concern with hysteria became one of enormous practical importance, since this was one of the totally disabling diseases among the soldiers of all armies. Moreover, the problem of distinguishing the malingerer from the hysteric that had face S. Weir Mitchell and W.W. Keen in the Civil war had become even more pressing in this much larger international conflict.. Actually, it is hard to see how Babinski's 'pithiasmic' concept could have been very helpful in this dilemma, although his discussion of treatment is a very positive and optimistic one. "The physician's task he saw simply as (a) the prevention of pithiatic disorders by means of hygiene and prophylaxis, and (b) the cure of this disorders once they have developed. Since they were caused by autosuggestion as well as by hetero-suggestion, the best prophylaxis was for physicians, nurses, and visiting friends always to weight their statements when visiting patients so as to avoid suggesting hysterical conditions. Therepeusis, in turn, demanded persuasion and countersuggestion and, above all, an atmosphere of confidence and faith. The confidence in the physician should also extend to his ability to distinguish organic disease from hysterical disorders and to treat it accordingly. "Needless to say, this point of view struck some of Babinsky's contemporaries, even those who greatly admired his neurological acumen as somewhat naive, and it failed to stir the medical imagination." "Babinsky concludes that certain Charcotian symptoms, including hysterical delusory states, must necessarily disappear from the collection of hysterical phenomena. Hysteria is stripped of every trace of madness. "The fragmentation of Charcot's concept of hysteria carried through in this was by Babinski is generally adopted. It is, however, not only unanimously accepted, but additionally and erroneously interpreted that hysteria is simulation and therefore does not exist. This was by no means Babinski's original intention since he crowns his definition of hysteria with a new signifier which seems more appropriate to him. He introduces the neologism pithiatism, i.e., curable by persuasion or conviction. His purification of Charcot's major hysteria this way unintentionally becomes the coup de grace of hysteria as such, since the misinterpretation of his view quickly find general acceptance."
"Janet's devotion to the word hysteria, and his desire to preserve it even though it had become etymologically meaningless, was not shared by all of Charcot's disciples. Babinski created a new term 'pythiatisme,' which to him expressed its most important features, since it combined the Greek words peitho, I persuade, and iatos, curable, believing that amenability to cure by persuasion was not only the most important characteristic of hysteria but also of diagnostic important. Although the term still lingers in the current medical dictionaries, it failed to become part of the general medical vocabulary.
The following might help our understanding of pithiatism, from Katrien Libbrect's HYSTERICAL PSYCHOSIS, New Brunswick: Transaction Publishers, 1995:
"After Charcot's death in 1893 Babinski turns from well-liked successor into the most important protagonist in the crucifixion of Charcot's hysteria. He explicitly takes the side of the (scientific) neurology against the psychological trend of Janet and focuses his research on signs that allow the differentiation between hysterical and neurological (lesional) disorders. In 1901 this brings him to a definition of hysteria in which the capacity of autosuggestion is the determinate element. His definition is purely pragmatical; hysteria is a collection of symptoms that can be produced by suggestion and which may disappear by means of counter-suggestion or persuasion. Charcot's experimental method of research is used here as a diagnostic means.
Finally, we may approach the subject with excerpts from Mark S. Micale's APPROACHING HYSTERIA, Princeton: Princeton University Press, 1995:
"Contemporaneously with the advance of neurological medicine and the emergence of a new nomenclature of the psychoses was the appearance of the 'neuropsychoses' as we know them today, the third medical area absorbing elements of the former hysteria diagnosis. Simply put, those portions of the old hysteria diagnosis that were not claimed decisively at this time by either mainstream organic medicine or institutional alienism were up for grabs by a young generation of doctors eager to theorize led the way in this process. Babinski, previously among the strongest adherents to the Salpetrian (Charcot) credo, repudiated his mentor's teachings bit by bit during the 1890s. In 1901, he proposed a new a much narrower definition of hysteria, to be christened 'pithiatism.' After years of deliberation, the Neurological Society of Paris voted to adopt Babinsky's neologism, and officially abandon 'hysteria' as a term of French medical terminology. In La semaine medicale, Babinski celebrated his linguistic victory in an essay that was tellingly subtitled 'On the Dismemberment of Hysteria.' In a parallel development, Janet contributed to the process of diagnostic dismantlement with his category 'psychasthenia.' Babinsky's pithiatism and Janet's psychasthenia are unfamiliar to Anglo-American readers today, but they remained influential in French psychological medicine until the 1930s. Both concepts illustrate clearly the fluid clinical relationship between the 'old' hysteria and the 'new' psychoneurosis."
