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Cognitive NeurologyA clinical textbook$
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Stefano Cappa, Jubin Abutalebi, Jean-Francois Demonet, Paul Fletcher, and Peter Garrard

Print publication date: 2008

Print ISBN-13: 9780198569275

Published to Oxford Scholarship Online: March 2012

DOI: 10.1093/acprof:oso/9780198569275.001.0001

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‘Others’ and others: hysteria and the divided self

‘Others’ and others: hysteria and the divided self

(p.459) Chapter 21 ‘Others’ and others: hysteria and the divided self
Cognitive Neurology

Sean A. Spence

Oxford University Press

In hysteria, a physical symptom or sign is said to be produced by a psychological mechanism, triggered by a conflict within the patient. Crucially, there is no explanatory physical cause that can be demonstrated. The man or woman so afflicted reports that they cannot raise their arm, or cannot see; yet physical investigations prove negative and, when sedated or observed unobtrusively over time, symptomatic inconsistencies arise. However, despite these, the diagnostic systems applied are quite specific that the patient experiencing and exhibiting such symptoms and signs is not responsible for their production, i.e. they are not ‘feigning’. Hence, the physician is called upon to judge what the patient is thinking and not doing, i.e. to perceive that they are really trying to move or see and are not pretending to be impaired. This is a complex task and the use of language in this area suggests considerable uncertainty among physicians as to what it is they are diagnosing.

Keywords:   hysteria, physical symptom, psychological mechanism, symptomatic inconsistencies, impaired, physical investigations

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