A Case of Hystero-Epilepsy Successfully Treated by Deep Analytic Psychotherapy

Abstract

To estimate the radical change that has come over medicine since the turn of the century it is worth considering for a moment the recently republished classical writings of J. Hughlings Jackson on Epilepsy and Epileptiform Convulsions. (1) Extensive and detailed as they are, they contain no hint of a possible psychological approach either to etiology or therapy. Both indeed are specifically rejected, the author taking the greatest pains throughout to keep psychology at a distance, as if it had no place in medicine proper. For instance, he describes most minutely the many and varied mental symptoms associated with epileptic attacks—both those before and those after the attack, when his acute clinical sense often takes him a long way; in his description and discussion of the “intellectual aura” and the “dreamy states” he would seem to be close to some modern views and discoveries. But for him such symptoms are only aids to diagnosis, mere pointers to underlying structural damage of the central nervous system, which is his only concern—viz. “Admitting that all mental states have parallel physical states I think our direct concern as … physicians is with the latter only” (vol. 1, p. 169). He comes to the conclusion that the study of epilepsy with a “psychological habit of mind” is “unfruitful.”