Hysteria; a case of bad science

Hi folks,

I actually had my letter of complaint about the bias nature of the recent article on therapeutic touch in Canadian Nurse (see post last month) published in their letters column, and boy did I get some venomous mail in response! I guess this isn’t that surprising, but sadly most were ad hominem attacks of the “how dare you, you positivist dinosaur” variety, rather than giving a good argument to support TT. Mind you I had a few e-mails supporting my position too, which is somewhat encouraging.

Anyhow, on to other matters. Last week I enjoyed watching the movie Hysteria, which was surprisingly good for a period rom-com, and has much to commend it. For those who have not heard of it, it explores the period in history when the medical fraternity used the diagnosis of “hysteria” to explain the female sexual response, and the following development of the vibrator. It handles the difficult sexual politics pretty well, and could easily have turned out another sensationalist sexploitation movie, but avoids that trap. There was also an excellent short documentary on the DVD about female sexuality and current legal position in many states in the USA, where the sale of such devices remains illegal. For example a US citizen in Texas can go into a gun store and purchase any manner of lethal armaments, but should they  wish to purchase a vibrator, apparently the vendor would be breaking the law. Come on you Texan’s get a grip on your legislature!

Anyhow, as an appalling example of bad science and medical practice, it is worth us considering further. Here we have an example of an incorrect theoretical basis (hysteria) used to explain a phenomena (the female sexual response) that was a product of the current socio-cultural paradigm of the time. I.e. it represented the views of male dominated, patriarchal victorian society. The female orgasm was more or less unrecognized by the medical profession, and was described as a paroxysmal response to mental instability, irrationality, resulting in relief, resolution and a return to clear thinking! My feminist colleagues are quite right to cite this as a key example of the male patriarchal dominance of the medical profession. Now we find this laughable, and hard to believe anyone could actually ignore the obvious, but that is because as we have (thankfully) moved forward somewhat in terms of sexual equality. Scientifically we have moved through what Thomas Kuhn would describe as a paradigm shift, and to my mind this is as good an example of that as any. My postmodern thinking colleagues would also probably also use this as an example of the unreliability of science.

The question, then arises as too how science would prevent this today. How do we know that our current explanations and theories are not equally incorrect in the explanation of phenomena. The answer is, of course, we can’t, and we have to recognize that any explanation of a phenomenon is rooted in our current understanding of the world, and social contexts. However, few modern scientists would dispute that, and post-Kuhnian science makes clear that we have to temper our explanations and be prepared to have them challenged, and overthrown as better explanations arise. Nevertheless, that does not mean we have a free-for-all and should consider any explanation is as good as any other. Modern science seeks to A) provide evidence a phenomenon actually exists (either directly or indirectly and at least providing a high probability), and B) provide a theoretical explanation that adequately explains that phenomenon. Now, the order in which those two components occurs can vary (which seems something a lot of academics get hung up on) but fundamentally the process is the same.

The beauty of science is that once we have undertaken this creative activity, we then open it up our ideas to debate, discussion and for others to test. Those hypotheses and explanations that seem to hold up become accepted and those that do not fall by the wayside.

With hysteria we had an observed phenomenon (the female orgasm) that was explained by a ludicrous theory of its time, but was eventually consigned to the scrap heap of duff ideas (although staggeringly, the diagnosis persisted into the 1950’s). Today, we likely have some some equally bad explanations, but as new discoveries arise, and by testing we can move forward. On the other hand, this does not mean we should not simply accept whatever explanation seems fashionable, or explanations that are irrational and unprovable when there are better ones available. Academic discrimination requires us to weigh up competing hypotheses and use the ones that seem to offer the best explanation given the current state of knowledge; not accept ones that conjecture fantastic and unprovable theories that are currently unsupported by any empirical work. It’s fine (and expected) for us to conjecture new explanations to overthow the old ones, but then we need to get to work and demonstrate they actually do offer a better explanation, and devise ways to demonstrate this. This sadly means science will progress slowly, in fits and starts, but at least if offers us a way to progress, and avoid getting bogged down for too long.

The alternative, is the “anything is possible “approach, which to my mind offers little hope for human progress, and worse opens up the potential for “anything is permissible” and history has shown us all too well where that leads. At least hysteria was eventually consigned to its rightful place in history as a defunct, useless and harmful theory. I just wish it had happened sooner, but with today’s information and communications technologies and possibility for anyone to challenge theories with a better idea, and things move a little quicker. That, to my mind, offers great hope for the future of science.

Onwards

Bernie

Bibleography:

Freud, S. (1888). Hysteria. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume I ( 1886-1899): Pre-Psycho-Analytic Publications and Unpublished Drafts, 37-59

Bernheimer C. & Kahane, C. (1990). In Dora’s Case; Freud – hysteria – feminism. New York, Columbia University Press.

Borch-Jacobsen,M. (2009);  Making Minds and Madness: from hysteria to Depression. Cambridge, United Kingdom; Cambridge University Press