Pierre Janet: The Mental State of Hystericals

(1892/1894; English 1901)

In 1875, the renowned French physiologist, Charles Richet, published an article on artificial somnambulism in the highly respected Journal de l’anatomie et de la physiologie.[1] The effect of this article was to repatriate the clinical study of hypnosis in France, retrieving it from the realm of popular pseudoscience into which it had fallen during the first half of the 19th century. From the early 1880s, a steady stream of publications reporting the use of hypnosis in the exploration of the unconscious emerged from the laboratories of Charcot and his collaborators at the Salpêtriere in Paris[2] and Bernheim and his coworkers at Nancy.[3] By 1889, when Hericourt summarized the work to date,[4] he could claim that the existence of unconscious mental activity had been proven beyond reasonable doubt.

In this same year, Pierre Janet, a student of Charcot, published L’Automatisme psychologique,[5]his doctoral dissertation and the first of a series of treatises on manifestations of the unconscious that were to establish his reputation as the founder of modern dynamic psychology. Janet was the first to articulate a theory of the unconscious mind aimed at replacing the unsystematic, prescientific and largely metaphysical theories that characterized 19th century Mesmerism; and he was the first to systematize careful, detailed clinical descriptions of various manifestations of the unconscious. As Ellenberger put it in Discovery of the Unconscious, “Janet stands at the threshold of all modern dynamic psychiatry. His ideas have become so widely known that their true origin is often unrecognized and attributed to others.”[6]

This is especially true of the ideas promulgated in Janet’s second major work, État mental des hystériques.[7] Translated into English in 1901 as The Mental State of Hystericals,[8] the État mental originally appeared in French in two installments. The first, published in 1892, dealt with symptomatology that Janet termed “mental stigmata.” Mental stigmata were symptoms essential to the hysterical condition, lasting about as long as the disease lasted, and opaque to patients, who were unaware of the exact source of their discomfort. The mental stigmata included anesthesias, amnesias, abulias, motor disturbances, and modifications of character.

The second installment, published in 1894, was devoted to “mental accidents.” Mental accidents were symptoms that were not necessarily characteristic of hysteria. They were relatively transient, accessible to patients who were well aware of the nature (although not the source) of their discomfort, and included subconscious acts, fixed ideas, emotional attacks, tics, ecstasies, somnambulisms, and deliriums.

The Mental State of Hystericals was a masterpiece of clinical description. Some of Janet’s most famous patients, Bertha, Celestine, Isabelle, Justine, Léonie, Lucie, Marcelle, Margaret, and Maria, appeared throughout the text, their symptoms described in exquisite detail. The fundamentally descriptive nature of the book was in line with the strong positivistic spirit of the French science of Janet’s day. Indeed, Janet took great pains to eschew anything that might be construed as metaphysical analysis.

Nonetheless, this was also a work known for its theoretical contributions. The most important of these was a general theory of hysteria that incorporated a view of the relationship between conscious and subconscious mind. Janet’s theory derived in part from his response to the perennial problem of accounting for the transformation of sensation into perception. How were sensations, existing below the level of awareness and fragmented both within and between sensory modalities, synthesized into a unified, personal consciousness?

In answer to this question Janet offered a theory which was both physiological and psychodynamic. “First, there is produced in the mind, in the cortical cells of the brain...a very large number of small, elementary, psychological phenomena, the results of...innumerable external excitations...(these are) subconscious phenomena...Secondly, there takes place a reunion, a synthesis of all these elementary phenomena, which are combined among themselves...(and then assimilated) to the vast and prior notion of personality...(to yield) a clearer and more complex consciousness.”[9] Sensations entered the field of consciousness, in other words, through the dual processes of cortical synthesis and active assimilation to that “enormous mass of thoughts already constituted into a system”[10] which was the personality.

But not all sensations entered consciousness. As Janet put it, even “with the best-constituted man there must exist a crowd of elementary sensations ...(that) remain what they are—namely, subconscious sensations, real, without doubt, and able to play a considerable role in the psychological life of the individual; but...not transformed into personal perceptions...”[11] The degree to which subconscious sensations came to awareness was termed by Janet, the “extent of the field of consciousness;”[12] and the extent of the field of consciousness was widely variable both between individuals and within a given individual over time.

In hysteria, the field of consciousness was subject to a pathological degree of contraction. This contraction of the field of consciousness “prevents those subject to it from connecting certain sensations with their personality.”[13] In anaesthesia, for example, the patient lost the ability to assimilate certain tactile and muscular sensations to personal consciousness; in amnesia, forgotten events could not be brought to consciousness even though they were available under hypnosis or through automatic writing.

Indeed, pathological contraction of the field of consciousness could leave the mind subject to the vagaries of a multitude of subconscious processes (e.g., suggestions, fixed ideas) that engaged the mind without being assimilated to the personality, that influenced perception, in other words, without themselves being perceived. Here was a powerful new conception of mind, mind as a psychodynamic system in which consciousness reflected the workings of subconscious process. This was, needless to say, a construction of mind that was to influence many later theorists, including both William James[14] and Sigmund Freud.[15]

[1]Richet, C. (1875). Du somnambulisme provoqué. Journal de l’anatomie et de la physiologie normales et pathologiques de l’homme et des animaux, 2, 348-377.

[2]See Charcot, J-M. (1890). Oeuvres complètes. Leçons sur les maladies du système nerveux. Paris: Progrès Médicale.

[3]Bernheim, H. (1884), De la suggestion dans l’état hypnotique et dans l’état de veille. Paris: Octave Doin, 1884; Bernheim, H. (1886). De la suggestion et de ses applications à la thérapeutique. Paris: Octave Doin; Bernheim, H. (1891). Hypnotisme, suggestion, psychothérapie. Etudes nouvelles. Paris: Octave Doin. For a discussion of the content and significance of Bernheim’s De la suggestion, see the essay on Bernheim in this volume.

[4]Héricourt, J. (1889). L’Activité inconscient de l’esprit. Revue scientifique, 3me series, 26, 2, 257-268.

[5]Janet, P. (1889). L’Automatisme psycholoqique. Paris: Félix Alcan.

[6]Ellenberger, H.F. (1970). Discovery of the Unconscious. The History and Evolution of Dynamic Psychiatry. New York: Basic Books, p. 406.

[7]Janet, P. (1892). État mental des hystériques. Les stigmates mentaux. Paris: Rueff; Janet, P. (1894). État mental des hystériques. Les accidents mentaux. Paris: Rueff.

[8]Janet, P. (1901). The Mental State of Hystericals. A Study of Mental Stigmata and Mental Accidents. New York: G.P. Putnam’s Sons.

[9]Janet (1901), op. cit., p. 36.

[10]Ibid., p. 35

[11]Ibid., p. 37

[12]Ibid., p. 38

[13]Ibid., p. 40

[14]See, for example, Taylor, E. (1983). William James on Exceptional Mental States, The 1896 Lowell Lectures. New York: Scribner’s.

[15]For an analysis of the relationship between Janet and Freud, see Ellenberger, op. cit.