CHECK YOUR HEAD
Six years after the end of the Gulf War, an epidemic rages among veterans. Every day new soldiers fall sick, but their symptoms are bewilderingly vague: migraines, muscle weakness, a loss of balance. Even so, the 60,000 or so soldiers suffering from Gulf War Syndrome insist that the outbreak can be traced directly to toxic exposures in Kuwait‹though medical studies have yet to pinpoint a causal agent. Researchers feel stymied. Does a latent retrovirus, like HIV, lurk inside the soldiers' bodies? Can brief exposure to pesticides and poison gas possibly lead to sickness years after the fact?
Elaine Showalter, the Princeton literary critic, offers a different diagnosis‹one that's sure to infuriate veterans. "It's male hysteria, pure and simple," she says. In her new book Hystories: Hysterical Epidemics and Modern Media (Columbia), Showalter depicts Gulf War Syndrome as but one of many illusory illnesses infecting the landscape, from chronic fatigue to multiple personality disorder to alien abduction. With a bluntness some readers will no doubt find glib, Showalter insists that our refusal to confront the reality of psychosomatic illness only prolongs suffering and encourages the spread of new hysterias.
Showalter, who for almost two decades has spent part of each academic year at London's Wellcome Institute for the History of Medicine, isn't without compassion for the "very real suffering out there." She simply feels that nothing good can come from fruitlessly searching for medical explanations of psychosomatic maladies. Instead, she wants to redefine hysteria as an almost humdrum affair, a "universal human response to emotional conflict" that affects men as well as women.
As commonplace as it is, the protean character of psychosomatic complaints makes them tricky to diagnose; their symptoms, Showalter writes, "mimic culturally permissible expressions of distress." In other words, those seduced-by-a-succubus stories of the nineteenth century have a way of becoming today's alien-abduction tales. It was no accident, says Showalter, that as an unhappy teenager in the Fifties she briefly adopted a polio-inflected limp‹mirroring the epidemic of the day. Similarly, our current fear of viruses engenders hysterias like "sick building" syndrome and the frenzy over Epstein-Barr, the putative source of chronic fatigue.
Showalter's book maps out "hystories," the pop-culture paths through which psychogenic illnesses propagate themselves. As a literary critic, Showalter finds that hysterical epidemics rely on stock narrative conventions. Like the Salem witch trials, hysterias typically originate in small, close-knit enclaves--such as Incline Village, the tiny Nevada retirement community where chronic fatigue first reared its weary head--or on military bases where veterans and their families trade rumors of Airborne Toxic Events. Then there are the inevitable guru figures, those doctors and therapists who provide "a clear and coherent explanation for...many confusing symptoms." Said gurus go about publicizing their breakthrough discoveries; before you know it, Oprah's clasping the hands of teary-eyed victims and Cher's confessing in Cosmo that she, too, is a long time sufferer. Conspiracies always loom large in hystories: When the medical establishment rejects the diagnosis, charges of a cover-up are sure to follow.
Showalter traces the hystory plot back to La Salpetriere, the Parisian clinic of Jean-Martin Charcot, the fin-de-siecle physician who became famous for treating hysterics through hypnosis. By putting his writhing patients on display at public lectures -- and photographing his favorite performers -- Charcot established an iconography of insanity that, Showalter argues, was picked up by subsequent patients. (As historians have noted, the quiverings and contortions of Charcot's patients -- which the doctor termed clownisme -- eerily resembled the melodramatic stylings of French actresses of the period.) By analogy, suggests Showalter, vulnerable people learn the recovered-memory script by watching carefully choreographed victims on Jenny Jones.
While some feminist scholars have tried to reclaim hysteria as a singular form of female self-expression‹interpreting, say, the persistent cough and migraines of Freud's patient Dora as emblems of outrage at her stultifying society life‹Showalter's goal is to defeminize (and deglamorize) a universal affliction. In fact, her project is more in line with Susan Sontag, whose Illness as Metaphor aimed to strip cancer and tuberculosis of their moral freight. "Hysteria is neither the sign of a higher consciousness nor the badge of a shameful weakness," Showalter writes. Under stressful conditions, anyone is susceptible.
But if psychosomatic illness is so damn ordinary, why use the loaded term "hysteria"? "I know people find it insulting, but it's the best way of underscoring historical continuity," she says. "I don't want to contribute to the constant renaming of the same illness." Take Gulf War Syndrome, for example: In the past century, it's been otherwise known as shell shock, combat fatigue, and post-traumatic stress disorder. "The Vietnam era helped educate the public about PTSD, but the Gulf War debate seems to exist in a historical vacuum," she laments.
Showalter thinks many of her feminist peers similarly fail to make historical connections. As she sees it, there's a contradiction between celebrating troubled "hysteric supermodels" like Dora and Anna O. while staunchly resisting the notion that contemporary women could be acting out similar psychic frustrations. "Literary critics are very astute when it comes to these dead women," she complains. "But when it's your friend or colleague‹oh, no, that would be insulting! Why can't modern hysteria be seen as equally dignified?" In fact, when Showalter offered up her hysteria thesis at the Dartmouth Theory Seminar in 1994, she was roundly criticized for doubting the legitimacy of recovered memory and chronic fatigue. "I was told in no uncertain terms: Don't go there," she says.
Then again, maybe the critics have a point. How can Showalter be so sure that all the syndromes she sneers at have no organic basis? As a medical historian, Showalter surely knows that before a disease is properly understood sick patients often meet maddening resistance from doctors. Knotty autoimmune diseases like lupus (which primarily affects women) often take years to diagnose properly‹early symptoms like fatigue and sun sensitivity can resemble malingering. Throughout much of this century, doctors dismissed multiple sclerosis as "the faker's disease." And in the age of AIDS, who can doubt that some syndromes can turn out to be devastatingly real?
Showalter feels her semesters in London have helped her discriminate between fact and illusion. "There's a lot more skepticism over there about, for example, Gulf War Syndrome," she notes, "and that skepticism influences the number of veterans who actually fall ill. In England, out of 45,000 soldiers, fewer than 700 cases have been reported." Indeed, she feels that "the best way to study illness is by looking at other cultures. When it's friends and family who are sick, it's hard to be objective." While we feel an understandable need to take Gulf War Syndrome seriously, it's hard not to laugh at Malaysian men who claim their penis is retracting into their belly. But to Showalter these are both culturally specific hysterias.
This past December Showalter published a fierce op-ed piece in The Washington Post denouncing the credulous reception given to Gulf War Syndrome; it incensed many veterans but caught the eye of the Pentagon. ("I've been contacted by officials from both the Army and Navy," Showalter reports.) For many academics, it's hard to imagine a more unsettling development‹a fan letter from Bill Gates might be the only thing worse‹but Showalter shrugs it off. "I have no hang-ups about this," she says. "I just want the truth to prevail. But I know I'm going to hurt a lot of feelings and make a lot of enemies." The thought of a book tour, in fact, makes her shudder. "But I'm undaunted," she says. "We've got to get these folks out of the rheumatologist's office and into therapy."