H-France Review Vol. 4 (January 2004), No. 4
Georges Didi-Huberman, Invention of Hysteria: Charcot and the Photographic Iconography of the Salpêtrière. tr. Alisa Hartz. Cambridge, Mass.: The MIT Press, 2003. xxi + 385 pp. Illustrations, appendixes, notes, bibliography, and index. $34.95 U.S. (cl.) ISBN 0-262-04215-0.
Review by Judith Surkis, Harvard Unversity.
The recent translation of Georges Didi-Huberman’s Invention of Hysteria: Charcot and the Photographic Iconography of the Salpêtrière, originally published in 1982 in French by Macula, will reintroduce this innovative, highly inter-disciplinary text to a new and wider audience. The book traces the implication of new photographic technologies in late nineteenth-century psychiatry’s attempt to develop newer and more precise taxonomies of mental illness. Dr. Jean-Marie Charcot, who occupied the Chair of Pathological Anatomy on the Paris Medical Faculty and was appointed to the newly created Clinical Chair of Diseases of the Nervous System at the Salpêtrière in 1881, exemplified this simultaneously visual and taxonomical orientation, especially in his work to isolate hysteria as a distinct type of nervous disease. The book details how the clinic’s photographic services and the publication of elaborate illustrated volumes were integral to this scientific project. A pathbreaking art historian, Didi-Huberman demonstrates how photographic technology helped to constitute, rather than merely document, Charcot’s work on hysteria.
The book itself is striking. Among its 107 beautifully reproduced illustrations and photographs are some of the Iconographie photographique de la Salpêtrière’s most arresting images, including the numerous “attitudes passionnelles” of Charcot’s “star” hysteric performer, “Augustine.” The photographs and images produced at the Salpêtrière are here placed in illuminating iconographic context, including Dr. Hugh Diamond’s photographs of madwomen at the Surrey County Asylum in England, Dr. Hippolyte Baraduc’s efforts to photograph the human soul, Alphonse Bertillon’s efforts to photograph, categorize, and classify criminals at the Préfecture de police of Paris, and Italian sociologist Cesare Lombroso’s photographs of the criminal women. Didi-Huberman attempts to go beyond the facile, albeit accurate, claim “that psychiatry simply became besotted with photography,” in order to explain its historically specific role in the production of psychiatric knowledge, as well as knowledge about “identity” more generally (p. 44).
Given a recent resurgence of interest in the historical study of visual cultures and technologies, this new translation is undoubtedly timely.[1] Didi-Huberman insists on the spectacular quality of hysteria, the “extreme visibility” (p. 3) of its suffering, especially in its incarnation at the Salpêtrière. Charcot himself referred to the clinic as a “living museum of pathology,” (pp. 17; 281) and, in his theory and practice, made connections between his visual techniques of clinical observation, the public display of his patients in his lectures, and the production and dissemination of knowledge. By the mid-1870s, photography became integral to Charcot’s epistemological project. With the increasing perfection of the technology, photographs required less exposure time (although still needing anywhere from twenty seconds to a minute) and could, unlike daguerrotypes, be reproduced. Photography was hence, Didi-Huberman claims, “in the ideal position to crystallize the link between the fantasy of hysteria and the fantasy of knowledge” (p. xi). It is the project of this book to explain how and why this was the case.
The hysteria “invented” at the Salpêtrière emerged, for Didi-Huberman, out of elaborate fantasies, which staged dynamics between sexual desire, scientific knowledge, and institutional power. That is to say, Charcot fantasized hysteria as a “secret” lodged in the feminine body which was all the more mysterious because of its spectacular symptoms (p. 69). This fantasy sustained a desire for knowledge of the feminine, hysterical body and could not be easily separated from the transferential relationships that developed between the clinic’s male doctors and their female patients. Sexual and epistemological desire converged in the doctors’ search for the secret of the hysteric’s illness, initiating a dynamic of seduction, or “reciprocity of charm,” (p. xi) between doctor and patient. The use (and abuse) of photographic technology provided a stage for the elaboration and acting out of these fantasies. The spectacular display of these, albeit disavowed, relations of seduction between doctor and hysteric, eventually became the primal scene of psychoanalysis itself, witnessed by a young Sigmund Freud, who had been drawn to Paris in 1885 by “the great name of Charcot” (p. 78).
Didi-Huberman brings to the fore the disturbing interplay of desire, knowledge, and power that has made the Salpêtrière an ongoing site of scholarly interest and investigation.[2] In contrast to historians who have sought to place Charcot’s work in the context of the politics of the French psychiatric profession, contemporary debates about the uneasy border between crime and madness, the “new psychology” and the aesthetic reimagining of interiority, or the history of hysteria and psychoanalysis, Didi-Huberman investigates the specific impact of photography on the relationship between doctors and their hysterical patients. His account recalls Foucault’s invocation of the Salpêtrière as both “an enormous apparatus for observation” and “a machinery for incitement,” an exemplary instance of the “perpetual spirals of power and pleasure” that, for him, characterized the “implantation of perversions” in the late nineteenth century.[3]
Didi-Huberman seeks to demonstrate the implication of hysterics themselves in the “invention” of hysteria, a role made possible by the psychiatrist’s use of a photographic technology that called on these patients to pose and act out for the camera. The book’s opening “Argument” thus foregrounds the play of the hysteric’s own desires in the spectacles staged at Charcot’s clinic: “What the hysterics of the Salpêtrière could exhibit with their bodies betokens an extraordinary complicity between patients and doctors, a relationship of desires, gazes, and knowledge” (p. xi). The hysteric is figured here, and throughout the book, not only as an object of a “male gaze,” but also as a subject, albeit masochistic, constituted by that gaze, whose own desires tragically consigned her to the exacerbation of her illness.
As its title, “Spectacular Evidence,” suggests, Part I is written under the sign of paradox. The first chapter expresses the author’s ambivalence regarding the aims of his book. What are the implications, he wonders, of treating this visible record of hysterical suffering as a chapter in the history of art? To what extent does the (art) historian replicate the voyeurism and scopic desire of the psychiatrist himself? At the same time, he suggests that the spectacularization of hysteria at the Salpêtrière cannot be understood without reference to the aesthetic and, in particular, to the “hypocrisy” of theatrical representation, that is to say “a recitation of truth through theatrical means,” (p. 7) which Didi-Huberman figures as the structuring principle and paradox of Charcot’s scientific endeavor. The second chapter sets the “scene,” by providing a brief history of the Salpêtrière and of Charcot’s rise to professional renown in the domain of neuropsychiatry. It further outlines Charcot’s famous “anatomo-clinical” method, which emphasized the repeated visual observation of external symptoms or signs of internal nervous disorders. Didi-Huberman here interrogates the extent to which the “spectacle ‘offered’ by pathological life” was necessarily staged; he treats Charcot as a “dramaturge,” (p. 23) whose apparently objective scientific practice relied upon procedures of casting, scripting, and spectacular display.
Chapter Three explores the historical intersection between the production of images and of scientific truth. Citing Charcot’s own claim to be “nothing more than a photographer” (p. 29), Didi-Huberman highlights how photography came to function as a metaphor and alibi for scientific objectivity in medicine, criminology, and psychiatry. The photograph provides evidence that something or someone “has been,” and hence appears to offer up a kind of knowledge. And yet what exactly does it prove? At work here, according to Didi-Huberman, is the central paradox of photographic “facticity,” its simultaneously “factual” and “factitious” (or artificial) character. This dynamic already structured the theatrical mise-en-scène of mid-century daguerrotype portraiture and continued to operate in the elaborate poses and staging of hysterics at the Salpêtrière. The fourth chapter argues that hysteria, like photography, was haunted by paradox. It offered up an enormous array of highly visible symptoms and yet seemed to issue from nowhere, or at least, no localizable pathology, giving rise to Charcot’s theorization of an elusive, “dynamic lesion” as its principal cause. This paradoxically spectacular and invisible illness, suggests Didi-Huberman, thus became an avatar of nineteenth-century femininity tout court.
In Part II, Charcot’s star performers take center stage. Inspired by Walter Benjamin’s writings on photography, Chapter Five searches for auratic traces of subjectivity in the photographs of Augustine from the Iconographie and metonymically links them to the “aura” that Charcot described as the state which preceded the onset of an hysterical attack. The suspended moments or gaps opened up in the photograph and the oncoming attack, argues Didi-Huberman, “compel us from the outset to be skeptical of images” (p. 102). The next chapter explores the gaps between the written text of the Iconographie, which recounts Augustine’s narrative fantasies--of rape, fires, beasts, amorous encounters--and the images of the “attitudes passionnelles” that she acted out during these hallucinations. Didi-Huberman highlights the psychiatrists’ spectacular “deafness” to the words of the hysterics that were nonetheless recorded in the Iconographie. Charcot’s failure to hear would be, of course, corrected by Freud’s discovery of “the other scene,” and of how unconscious fantasies become converted into highly visible hysterical symptoms. At the Salpêtrière, the lack of reciprocity between doctor and patient, actualized by the mediation of the camera, solicited the hysteric’s repeated fantasies and hallucinations while simultaneously sustaining those of the doctors to whom these scenes were offered up. The hysteric’s seduction of her doctors was, according to Didi-Huberman, “a law of the institution,” “a forced tactic,” for, if she refused to play along, she might be consigned to the ranks of the incurably mad (p. 170). The disavowal of the transferential relationship that was all the while operating between doctor and patient fueled the spectacular creativity of the hysteric’s symptoms.
Charcot, in turn, famously employed a variety of experimental techniques in order to reproduce and restage these symptoms. Chapter Seven outlines these techniques as well as their photographic representation, providing a disturbing account of the procedures to which the hysterics’ bodies were submitted, including hypnotism, electric shocks, magnetism, chemical intoxication with ether and amyl nitrate, deafening by gongs, and penetration by needles. These experiments required a laying on of hands, an intimate contact between doctor and patient, that was tellingly occluded by their photographic reproduction in the Iconographie (although described by the text and sometimes featured in sketched images). For Didi-Huberman, this absence speaks volumes; it is so much evidence that “the desire of the physicians of the Salpêtrière was, fundamentally, a desire that dared not speak its name” (p. 235). Or, perhaps better, show its face. This creative production and reproduction of visible symptoms, this acting out of the physician’s fantasies, could only last as long as the transferential relationship that sustained it. Once broken, the hysteric might refuse to follow the script, or perhaps even cease performing altogether. And it is with just such a dénouement, and Augustine’s eventual escape from the institution, that Didi-Huberman concludes his book.
In keeping with its use of an extended theatrical metaphor, Didi-Huberman’s text is highly performative, which is to say that it “acts out” its argument. Given its skepticism regarding Charcot’s attempt to create a “unified tableau” of hysteria, the book privileges paradox, aporia, and contradiction, pointing to the gaps and impasses disavowed by Charcot himself, which frustrate efforts to obtain absolute knowledge. Devoted to Charcot’s attempt to produce a coherent diagnostic category out of hysteria’s seemingly incoherent systems, the text itself resists clear disciplinary categorization, with its mix of historical, philosophical, aesthetic, and literary sources and styles of writing. In its account of the physicians’ and hysterics’ fantasies, the book’s argumentation appeals to rhetorical techniques, which resemble Freud’s “dream work,” to procedures of condensation and displacement, metaphor and metonomy, rather than linear, causal analysis. Word play is thus central to Didi-Huberman’s argument, and translator Alisa Hartz has impressively captured both the feel and sense of the original text.
As its title indicates, the book’s principal source base is the Iconographie photographique de la Salpêtrière, published in three volumes, between 1876 and 1880. While it references Charcot’s published lectures and complete works as well as those of his associates, D.-M. Bourneville, Albert Londe, and Paul Richer, it does not make use of archival sources. An appendix of twenty-two extended excerpts, mostly by these authors, provides the reader with the opportunity to study the “key texts” with which Didi-Huberman constructs his argument. The book’s highly concentrated emphasis has the advantage of plunging the reader into the textual and iconographic world of the Salpêtrière. In largely confining itself to the hothouse atmosphere contained by the asylum walls, the text reproduces a sense of claustrophobia and encourages identification, on the one hand with Augustine’s final fugue and, on the other, with Freud’s conceptual break from Charcot.
The book’s argument is implicitly contextual in its invocation of how developments in photographic technology helped to shape “vision” in historically specific ways. The text, however, only hints at the connections between the fantastic world of the clinic and that outside, despite the fact that Charcot rather famously rendered the boundary between them more permeable, initiating a new system of outpatient care and making his Tuesday lectures public. Indeed, the presence of this public subtends Didi-Huberman’s figuration of Charcot as an entertainer of sorts. He alludes to Charcot’s attempt to establish a medical monopoly over hypnosis in order to distinguish himself from his quack contemporaries (pp. 235-237). In light of recent work on modern mass entertainment, as well as the shifting role and representation of actresses in fin-de-siècle culture and the implication of theater in the gender politics of the Third Republic,[4] Didi-Huberman’s invocation of these spectacles, animated as they are by conventional heterosexual fantasies, may feel insufficiently contextualized. “Theater” and the desires that are presumed to motivate its mise-en-scène, explain the disavowed reality of the clinic, but are themselves unexplained and underanalyzed. Indeed, at times, the argument becomes carried away by its own dramatic metaphorics. The hysterics at the Salpêtrière, however “theatrical” their gestures, were not actresses in the conventional sense, they were largely working-class women consigned to an asylum and subject to the discretion of their doctors. Didi-Huberman alludes to the perpetual threat under which they lived when he refers to seduction as a tactic forced on the hysteric. But these concrete relations of institutional as well as class power become somewhat obscured by the scenario of heterosexual seduction. In his effort to understand how and why the patients could have participated in Charcot’s fantasy of hysteria, he provocatively imagines them as desiring subjects, rather than as mere objects of a masculine medical gaze. But, in the end, Didi-Huberman’s model of feminine consent is, fundamentally, masochistic. And we are left wondering whose fantasy this is.
In drawing connections between the role of fantasy and performativity in late nineteenth-century knowledge production and subject formation, The Invention of Hysteria remains remarkably contemporary. Twenty years after its original publication, this text maintains its ability to surprise and sometimes to shock, by providing fascinating insights into the imbrication of art and science, knowledge and desire, rationality and irrationality, in the microcosm of Charcot’s Salpêtrière.
NOTES
[1] See, for example: the recent special issue “French History in the Visual Sphere,” Daniel J. Sherman and Mary D. Sheriff, eds., French Historical Studies 26/ 2 (Spring 2003); Teresa Brennan and Martin Jay, eds., Vision in Historical Context: Historical and Contemporary Perspectives on Sight (New York: Routledge, 1996); Jonathon Crary, Suspensions of Perception: Attention, Spectacle and Modern Culture (Cambridge, Mass.: The MIT Press, 1999); Vanessa Schwartz, Spectacular Realities: Early Mass Culture in Fin-de-siècle Paris (Berkeley: University of California Press, 1998). The following remain indispensable reference points: T.J. Clark, The Painting of Modern Life: Paris in the Art of Manet and his Followers (Princeton, N.J.: Princeton University Press, 1986) and Jonathon Crary, Techniques of the Observer: On Vision and Modernity in the Nineteenth-Century (Cambridge, Mass.: The MIT Press, 1990).
[2] Some of the principle works which have sought to place Charcot’s work at the Salpêtrière in a variety of institutional, cultural, and political contexts include: Martha Noel Evans, Fits and Starts: A Genealogy of Hysteria in Modern France (Ithaca, N.Y.: Cornell University Press, 1991); Jan Goldstein, Console and Classify: The French Psychiatric Profession in the Nineteenth Century (New York, NY: Cambridge University Press, 1987); Ruth Harris, Murders and Madness: Medicine, Law and Society in the Fin-de-siècle (Oxford: Clarendon Press, 1989); Jann Matlock, Scenes of Seduction: Prostitution, Hysteria and Reading Difference in Nineteenth-Century France (New York, NY: Columbia University Press, 1994); Mark S. Micale, Approaching Hysteria: Disease and its Interpretations (Princeton: Princeton University Press, 1995); Elisabeth Roudinesco, La Bataille de cent ans: Histoire de la psychanalyse en France, vol.1 (Paris: Ramsay, 1982); Debora Silverman, Art Nouveau in Fin-de-siècle France: Politics, Psychology, Style (Berkeley: University of California Press, 1989).
[3] Michel Foucault, The History of Sexuality, vol. 1, trans. Robert Hurley (New York: Vintage, 1980): 55, 45.
[4] On mass spectacle, see: Crary, Suspensions of Perception and Schwartz, Spectacular Realities. On theater, feminism, and the ‘new woman’: Lenard R. Berlanstein, Daughters of Eve: A Cultural History of French Theater Women from the Old Regime to the Fin-de-Siècle (Cambridge, Mass.: Harvard University Press, 2001); Jean E. Pedersen, Legislating the Family: Feminism, Theater and Republican Politics, 1870-1920 (New Brunswick, N.J.: Rutgers University Press, 2003); Mary Louise Roberts, Disruptive Acts: The New Woman in Fin-de-siècle France (Chicago: University of Chicago Press, 2001); as well as, Crary, Suspensions of Perception and Schwartz, Spectacular Realities.
Judith Surkis
Harvard University
surkis@fas.harvard.edu
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H-France Review Vol. 4 (January 2004), No. 4
ISSN 1553-9172
