La photographie avec l’hypnose : comprendre l’hystérie
Photography with Hypnosis: Understanding Hysteria
Stephanie Garcia – March 12, 2023
How and why did Charcot use photography together with hypnosis in order to make sense of hysterical symptoms?
The History of Jean-Martin Charcot and the Salpêtrière
In neurology at the end of the nineteenth century, two of the diseases that most concerned neurologists were neurosyphilis and hysteria. Jean-Martin Charcot’s particular interest in hysteria developed when he took over the Delasiauve ward, where people with epilepsy and hysteria were admitted. Charcot regarded hysteria as a “neurosis with an organic basis,” yet these patients showed no visible lesions in the brain. Instead, he believed there was a “dynamic lesion” in the brain responsible for hysterical patients’ symptoms, such as hyperexcitability and sensory dysfunction, which led him to classify these patients as suffering from “grand hysterical attacks” (grandes crises d’hystérie) (Bogousslavsky et al., 2009).
Charcot’s research led him to think that trauma was an integral component of hysteria: trauma could trigger a hysterical response, and it could also take the form of a mental representation that persisted during a long latent phase in the patient. Freud and Breuer would later theorise, in another context, that children go through a “latency phase” marked by a regression in sexual development. Charcot’s ideas contributed to some of the earliest theoretical developments around hysteria.
It was in 1878 that Charcot began using hypnosis with his hysterical patients. Since he had hypothesised that hysteria and epilepsy were organic neuroses without visible brain lesions, he and his colleagues believed that a patient’s ability to be hypnotised was a clinical sign of hysteria. This is why Charcot and his peers repeatedly tried to prove this hypothesis during public demonstrations, especially at the Salpêtrière, where many medical professionals became convinced that susceptibility to hypnosis was synonymous with hysteria (Bogousslavsky et al., 2009).
Photography in France at the End of the Nineteenth Century
At the time, hypnosis was considered the bridge between normality and abnormality, and the people who crossed that bridge were patients diagnosed with hysteria. Authors writing about hypnosis believed and wanted to normalise hypnosis as a transition process between states that could be described and characterised by science. However, others, such as spiritualists, thought that hypnosis was a phenomenon belonging to domains that could not be explained “in materialist terms” (Roth, 1996).
Amid the controversies about what hypnosis is and what it does, both medical practitioners and spiritualists agreed on one thing: photography was the perfect tool for remembering the materialisation of spiritual or mental phenomena. Photography was prized because it was a technology capable of reproducing the real physical world perfectly. Photographers could not only depict ordinary aspects of everyday life but also seek out and capture anomalies and extremes, since photography and the camera were tools for investigating whether other realms and modes of existence were possible (Roth, 1996).
Charcot’s Photography
How did Charcot use photography in connection with hypnosis to better understand hysteria? In what way was combining these two popular practices revolutionary?
Charcot established himself as a renowned neurologist by investigating the causes and famous phases of hysteria and by using hypnosis at the Salpêtrière. Why did he choose to use photography to explore hypnosis in his hysterical patients?
The Images
Jean-Martin Charcot demonstrating hysteria in a hypnotised patient at the Salpêtrière
Etching by A. Lurat, 1888, after a painting by André Brouillet, 1887.
The Meaning of the Photographs
In this image, Jean-Martin Charcot is shown standing in the middle of a large room next to a woman, his left arm lightly supporting her back. Behind the woman, a man and two nurses appear concerned about her condition. Her head is thrown back, her arms are rigid behind her, and her spine is curved backwards, as if she had fallen asleep while standing in the middle of the room. Next to the two nurses, the foot of a hospital bed can be seen, as though it were ready for her to lie down again.
On the left-hand side of the image, a large group of older men in professional attire is visible, most of them seated in front of Charcot, with a row standing at the back. All eyes are fixed on Charcot and his patient; some attendees are even hastily taking notes on what Charcot is presenting. This photograph (or, strictly speaking, this image as reproduced) illustrates one of the three main functions of photography: its pedagogical function. It was taken during one of the famous Tuesday Lectures (Leçons du Mardi) at the Salpêtrière, where Charcot demonstrated his hypnotic techniques to an audience (Florsheim, 2016).
The value of the image rests almost entirely on Charcot, who is clearly the focal point. The image exposes the dynamics between Charcot as principal investigator, the patient, and his colleagues. Power is concentrated in Charcot’s hands: he is the one pushing the limits of knowledge about hysteria — everyone else in the room is secondary to him. Charcot was strongly influenced by the work of Charles Richet, especially his work on induced somnambulism, which Charcot operationalised by using hypnosis with his hysterical patients. Live demonstrations in front of the Salpêtrière school were appealing to his intellectual peers, since for them susceptibility to hypnosis was a sign of illness, in this case hysteria (Bogousslavsky, 2009).
In another pair of photographs, we see a patient caught between two phases of the hypnotic process: lethargy and catalepsy. In the left-hand image, a woman wearing what appears to be a nurse’s uniform is lying horizontally in mid-air. The photograph is framed to give the impression that she is levitating. In the background, there is a dark floral curtain and two wooden chairs. The patient rests her hands on her abdomen.
In the right-hand image, we see the same patient in a different phase. She is no longer suspended horizontally in the air; the bottom of her dress seems to touch the wooden floor, which probably means her feet are planted on the ground. Her hands now rest on her chest, close to her neck. Her body remains in an unnatural position, with her spine bent backwards at a right angle to her legs. Unlike in the left-hand photo, the patient’s eyes are closed. To induce catalepsy, one produces a sudden loud noise or strikes the patient with a blinding object, but the most notable feature of the cataleptic phase is the patient’s immobility (Dessoir, 1887). The lethargic phase is characterised by hyperexcitability of nerves and muscles (Dessoir, 1887).
The photographs only show the patient in profile, which creates a sense of anonymity because viewers cannot see her full face. Although Charcot likely wanted to focus on the patient’s bodily movements during a hypnotic phase, the images produce a different effect. Viewers do not perceive this woman as a human being undergoing treatment for an illness; rather, she appears as a bizarre, unnatural shape. With the help of a young physician, Paul Regnard, Charcot aimed to describe his patients during hypnotic phases not only to provide a visual representation of how each phase unfolds, but also as part of an attempt to divide hypnosis into distinct moments and categories (Florsheim, 2016).
Another pair of photographs documents the cataleptic phase of hypnosis. In the first photo, a woman in everyday dress, wearing a long buttoned gown, extends her right arm fully upward while her left arm crosses over her torso at a lower angle. Her palms seem stiff, while her fingers appear more relaxed. Her torso tilts slightly left, and her gaze is directed toward her left hand.
In the second photograph, another woman wearing a long fur-lined coat holds both arms raised, slightly bent at the elbows. Her hands look fragile as they hover near the top of her head. Her gaze is fixed on her left hand. Both images emphasise the strangeness and fixation on arm and hand positions. The woman on the left appears confused; the one on the right looks dazed.
Since catalepsy is defined by immobility, it makes sense that these women seem perplexed by their own bodies; they cannot move their arms and hands as they wish. These two photos are ambiguous: the women appear not to control their own movements, prompting the question: who or what is controlling them? Is it the severity of their hysterical symptoms, or the fact that Charcot instructed them to pose a certain way? In either case, power is taken away from these women, leaving room for interpretation by viewers. Charcot wanted to emphasise the importance of the first stages of hypnosis because this practice allowed him to translate his perception of hysteria into terms that others could see, at a time when “photography was perceived as an absolutely objective record of reality” (Florsheim, 2016). In this way, Charcot could “objectively” record the reality of hysteria and show how hypnotic procedures on patients “proved” the existence of the illness to others.
Another set of two photographs shows patients in the lethargic phase of hypnosis. In the left-hand image, a woman is seated while a nurse stands beside her. The patient’s hands are clasped together like crab claws. Her neck is thrown back, exposing her throat; the nurse supports the weight of her head. The patient’s eyes are closed. In the right-hand image, the nurse carries and lifts the patient in her arms. Her eyes are also closed, and her upper body is arched backwards. Both patients appear to have fainted, and the nurses are there to hoist their unconscious bodies.
The lethargic phase was described as a state of deep sleep in which the patient remains immobilised and rigid (Dessoir, 1887). The nature of these two photographs undermines the competence and agency of women, especially Charcot’s hysterical patients. The women are unconscious, which suggests that the burden of illness is too heavy for them. These images allow Charcot to exercise power over his patients, which he does through the practice of hypnosis. Charcot and his collaborators perceived something particular in hypnotism, compelling them to understand it more fully, not only clinically but also nosographically — something made possible by photographing the hypnotic phases (Dessoir, 1887).
Two additional photographs show two women lying on hospital beds. Both patients wear white hospital gowns. In the left-hand image, the woman’s body is lifted above the bed; the lower half of her body does not touch the sheets. Her knees are bent at a right angle and her forearms are placed behind her back to support the weight of her raised torso. Her face is not visible. In the right-hand image, another woman sleeps on a large pillow, her head turned to her right. Her arms lie straight at her sides, with both wrists bent so that her palms and fingers face down. These photographs depict patients in the midst of hysterical epilepsy. The bizarre positions of their bodies match Charcot’s understanding of hysteria.
Hysteria was considered an organic neurosis, notable precisely because hysterical patients had no physical brain lesions. Nonetheless, the body showed physical manifestations. Charcot chose these photographs to demonstrate how overwhelming hysteria’s effects could be on the body. The subjects are depicted as lifeless and disturbed, which not only helped Charcot obtain striking images to publish as medical photographs, but also allowed him to explore other methods of understanding hysteria — in this case, hypnosis. The strangeness of hysterical behaviour spurred Charcot and other physicians to investigate the causes of hysterical-epileptic attacks more deeply. Charcot believed that the ability to be hypnotised was a clinical sign of hysteria. This supposed proof allowed him to develop typologies of normality (absence of hysteria) and abnormality (presence of mental illness) (Florsheim, 2016).
Conclusion
Although hysteria is no longer recognised as a legitimate psychiatric diagnosis, Jean-Martin Charcot must be credited with the ingenuity of using photography to capture images of his hysterical patients: it was the first time that the nature of an illness could be translated from a health professional’s perspective to the broader public. Charcot carefully selected his patients’ poses and overall visual presentation in order to defend and normalise the use of hypnosis as a tool for understanding hysteria in the nineteenth century.