Hysteria by Katerina Bryant

‘…the oldest and strongest emotion of mankind is fear, and the oldest and strongest kind of fear is fear of the unknown.’ (H.P. Lovecraft)

Katerina Bryant’s memoir, Hysteria, recounts her search for a diagnosis for chronic illness. Bryant was experiencing seizures, episodes that struck without warning and where she felt disconnected from her body.The seizures left her feeling anxious, exhausted and increasingly fearful of participating in ordinary activities.

Doctors wavered between diagnosing epilepsy, conversion disorder, or psychogenic non-epileptic seizures (PNES). Meanwhile, Bryant considered the possibility of ‘old-fashioned’ hysteria –

Labels are tricky things and I piece together that hysteria seems to be the absence of a diagnosis.

Hysteria is well documented, and Bryant weaves historical case studies of women with broadly similar conditions to her own, through her story.

…hysteria is a fluid diagnosis that throughout history has presented in varied ways. Yet, even today, when hysteria is mentioned, an image of a shaking, manic woman comes to mind.

The case studies reveal that in many ways, little has changed over time. The stigma associated with mental illness, and the way that the experiences of people suffering from illness that you can’t ‘see’ are marginalised, remains. Through her own experience of having various possible diagnoses, Bryant was living the mind-body dualism that governs Western medicine.

It’s difficult for me not to slip into the line of thinking that with conversion there is a less serious risk of harm than epilepsy.

This was particularly notable when it came to the financial cost of her diagnosis – CT scans and EEGs are bulk-billed, therefore, you’re financially ‘better off’ to have something wrong with your brain than you are to have something wrong with your mind (access to adequate mental health support is often cost prohibitive over the long term).

She highlights these differences again with language – ‘I am mentally ill’ versus ‘I have cancer’. The language suggests that mental illness is you, whilst cancer is only one part of you (noting that no one ever says ‘I am cancerous’).

Ultimately, Bryant finds help via a psychologist who is not interested in why she is ill, but instead in how he can help her live. Of her episodes, she says –

Dr Robert and I decide that while I have no control over when they occur or how they present, my own reaction to them will change how much effect they have.

This ‘acceptance’, is contrary to the broad approach of Western medicine –

We’re so often told to fight an illness, as if all illness were something we could conquer if we tried hard enough.

There is much more to this book – notably, the role of gender in medicine and treatment (and this is particularly relevant in psychiatry where ‘hysterical women’ were, and are, subjects for ‘hero’ male doctors); the belief that you don’t deserve help because others are suffering ‘more’; and Bryant’s understanding that she may live the rest of her life with an ‘illness’, and the ambiguous grief associated with that.

Medical and mental health memoirs are one of my favourite memoir sub-genres, and Bryant’s use of case studies broadens the appeal of this book. Her writing is engaging, honest, and the case studies provide robustness to her story, without interfering with the personal perspective.

4/5 Wonderful insights.

One of Katerina’s first episodes occurs in a restaurant, over plates of salt and pepper calamari, and egg noodles.

7 responses

  1. This looks right up my street! Thanks for making me aware of it. Suzanne O’Sullivan’s first two books also consider patients who experience seizures but do not have epilepsy.

    That’s an interesting note about the language people use. Dara McAnulty (a teenage nature writer here in the UK) is careful to always say “I am autistic” (i.e., it is part of his identity) rather than “I have autism” (which would suggest it is an unfortunate medical condition).

    • I think you would like his one.
      Interesting to hear what McAnulty says – opposite of what this author is suggesting! I guess the key is that it is a very personal thing. Either way, a discussion about it raises awareness of the differences for people. I am very careful at work to listen to the language people use about their own diagnoses for this very reason.

  2. As a reader of old books it often seems that women suffered from conditions that no longer exist. And yes corsets is one explanation. But so I think are expectations, and silly young (wealthy) women were expected to fall down and faint when something went wrong, and so they did. Hysteria is an interesting word, containing at least hints of condemnation, but I am sure it is continuous with the current diagnosis of Anxiety – which itself was subject to “just get over it”.

    • Corsets! :-O

      The over-arching message in this book was ‘when we don’t know what to do with someone (a woman), we label them with hysteria’ – I agree, that that happens today with anxiety. Unfortunately, that overlooks the nuances of anxiety and, like all mental health conditions, anxiety exists on a spectrum (when applying labels, people forget that we are ALL on the spectrum!).

  3. That’s such an interesting point about “I am mentally ill” vs “I have cancer”. I also rather dislike the language of “fighting” illness. I’ve seen the way it can make people feel guilt and shame when they can’t simply win against their illness.

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