We use the expression “throw a tantrum” very often, but few people think about the fact that this is not simple behavioral promiscuity, but a real disease, with its own symptoms, clinic and treatment.

What is a hysterical attack?

A hysterical attack is a type of neurosis, manifested by indicative emotional states (tears, screams, laughter, arching, wringing of hands), convulsive hyperkinesis, periodic paralysis, etc. The disease has been known since ancient times; Hippocrates described this disease, calling it “rabies of the uterus,” which has a very clear explanation. Hysterical fits are more typical for women, they are less likely to bother children and occur only as an exception in men.

Professor Jean-Martin Charcot shows students a woman in a hysterical fit

At the moment, the disease is associated with a certain personality type. People subject to attacks of hysteria are suggestible and self-hypnosis, prone to fantasizing, unstable in behavior and mood, love to attract attention with extravagant actions, and strive to be theatrical in public. Such people need spectators who will babysit and care for them, then they receive the necessary psychological release.

Often, hysterical attacks are associated with other psychosomatic deviations: phobias, dislike of colors, numbers, pictures, conviction of a conspiracy against oneself. Hysteria affects approximately 7-9% of the world's population. Among these people there are those who suffer from severe hysteria - hysterical psychopathy. The seizures of such people are not a performance, but a real disease that you need to know, and also be able to provide assistance to such patients. Often, the first signs of hysteria appear already in childhood, so parents of children who react violently to everything, bend over backwards, and scream angrily should be shown to a pediatric neurologist.

In cases where the problem has been growing for years and an adult is already suffering from severe hysterical neuroses, only a psychiatrist can help. An examination is carried out individually for each patient, an anamnesis is collected, tests are taken and, as a result, specific treatment is prescribed that is suitable only for this patient. As a rule, these are several groups of drugs (hypnotics, tranquilizers, anxolytics) and psychotherapy.

Psychotherapy in in this case prescribed for opening those life circumstances that influenced the development of the disease. With its help, they try to level out their significance in a person’s life.

Symptoms of hysteria

A hysterical attack is characterized by an extreme variety of symptoms

A hysterical attack is characterized by an extreme variety of symptoms. This is explained by the self-hypnosis of patients, “thanks to” which patients can depict the clinic of almost any disease. Seizures occur in most cases after an emotional experience.

Hysteria is characterized by signs of “rationality”, i.e. the patient experiences only the symptom that he “needs” or is “beneficial” at the moment.

Hysterical attacks begin with hysterical paroxysm, which follows an unpleasant experience, a quarrel, or indifference on the part of loved ones. A seizure begins with the corresponding symptoms:

• Crying, laughing, screaming
• Pain in the heart area
• Tachycardia (rapid heartbeat)
• Feeling short of air
• Hysterical ball (feeling of a lump rolling up to the throat)
• The patient falls, convulsions may occur
• Hyperemia of the skin of the face, neck, chest
• Eyes are closed (when trying to open, the patient closes them again)
• Sometimes patients tear their clothes, hair, and hit their heads

It is worth noting features that are not characteristic of a hysterical attack: the patient has no bruises, no bitten tongue, the attack never develops in a sleeping person, there is no involuntary urination, the person answers questions, there is no sleep.

Sensitivity disorders are very common. The patient temporarily ceases to feel parts of the body, sometimes cannot move them, and sometimes experiences severe pain in the body. The affected areas are always varied, it can be the limbs, the abdomen, sometimes there is a feeling of a “driven nail” in a localized area of ​​the head. The intensity of the sensitivity disorder varies, from mild discomfort to severe pain.

Sensory organ disorder:

• Visual and hearing impairment
• Narrowing of visual fields
• Hysterical blindness (can be in one or both eyes)
• Hysterical deafness

Speech disorders:

• Hysterical aphonia (lack of sonority of voice)
• Muteness (cannot make sounds or words)
• Chant (syllable by syllable)
• Stuttering

A characteristic feature of speech disorders is the patient’s willingness to enter into written contact.

Movement disorders:

• Paralysis (paresis)
• Inability to perform movements
• Unilateral hand paresis
• Paralysis of the muscles of the tongue, face, neck
• Trembling of the whole body or individual parts
• Nervous tics of facial muscles
• Arching the body

It should be noted that hysterical seizures do not mean real paralysis, but an elementary inability to make voluntary movements. Often, hysterical paralysis, paresis, and hyperkinesis disappear during sleep.

Disorder internal organs:

• Lack of appetite
• Swallowing disorder
• Psychogenic vomiting
• Nausea, belching, yawning, cough, hiccups
• Pseudoappendicitis, flatulence
• Shortness of breath, imitation of an attack bronchial asthma

At the core mental disorders lies the desire to always be the center of attention, excessive emotionality, inhibition, psychotic stupor, tearfulness, a tendency to exaggerate and the desire to play a leading role among others. All the patient’s behavior is characterized by theatricality, demonstrativeness, and to some extent infantilism; one gets the impression that the person is “glad about his illness.”

Hysterical seizures in children

Symptomatic manifestations of mental seizures in children depend on the nature of the psychological trauma and on the personal characteristics of the patient (suspiciousness, anxiety, hysteria).

Typical for a child increased sensitivity, impressionability, suggestibility, selfishness, instability of mood, egocentrism. One of the main features is recognition among parents, peers, society, the so-called “family idol”.

For children younger age It is common to hold your breath when crying, provoked by the child’s dissatisfaction and anger when his requests are not satisfied. At older ages, the symptoms are more varied, sometimes similar to attacks of epilepsy, bronchial asthma, and suffocation. The seizure is characterized by theatricality and lasts until the child gets what he wants.

Less commonly observed are stuttering, neurotic tics, blinking tics, whining, and tongue-tiedness. All these symptoms arise (or intensify) in the presence of persons towards whom the hysterical reaction is directed.

A more common symptom is enuresis (bedwetting), more often due to changes environment (new kindergarten, school, home, the appearance of a second child in the family). Temporarily removing the baby from a traumatic environment can lead to a decrease in diuresis attacks.

Diagnosis of the disease

The diagnosis can be made by a neurologist or psychiatrist after the necessary examination, during which an increase in tendon reflexes and tremor of the fingers are noted. During the examination, patients often behave unbalanced, may groan, scream, demonstrate increased motor reflexes, spontaneously shudder, and cry.

One of the methods for diagnosing hysterical seizures is color diagnostics. The method represents the rejection of a certain color during the development of a particular condition.

For example, a person is unpleasant orange, this may indicate low self-esteem, problems with socialization and communication. Such people usually do not like to appear in crowded places; it is difficult for them to find common language with others, make new friends. Rejection of the color blue and its shades indicates excessive concern, irritability, and agitation. Dislike for the color red indicates disturbances in the sexual sphere or psychological discomfort that arose against this background. Color diagnostics is currently not very common in medical institutions, but the technique is accurate and in demand.

First aid

It is often difficult to understand whether the person in front of you is sick or an actor. But despite this, it is worth knowing the mandatory first aid recommendations in this situation.

Don’t persuade the person to calm down, don’t feel sorry for him, don’t be like the patient and don’t panic yourself, this will only encourage the hysteroid even more. Be indifferent, in some cases you can go to another room or room. If the symptoms are violent and the patient does not want to calm down, try spraying him in the face cold water, bring it inhale the vapors ammonia, give a gentle slap in the face, press on the painful point in the ulnar fossa. Do not indulge the patient under any circumstances; if possible, remove strangers or take the patient to another room. After this, call your doctor before arriving medical worker don't leave the person alone. After an attack, give the patient a glass cold water.

During an attack, you should not hold the patient’s arms, head, neck or leave him unattended.

To prevent attacks, you can take courses of tinctures of valerian, motherwort, and use sleeping pills. The patient’s attention should not be focused on his illness and its symptoms.

Hysterical seizures first appear in childhood or adolescence. With age, clinical manifestations smooth out, but in the menopause they can again appear and worsen. But with systematic observation and treatment, exacerbations pass, patients begin to feel much better, without seeking help from a doctor for years. The prognosis of the disease is favorable if the disease is detected and treated in childhood or adolescence. We should not forget that hysterical fits may not always be a disease, but only represent a personality trait. Therefore, it is always worth consulting with a specialist.

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Hysterical attack or hysterical attack- a way of expressing the emotions of a hysterical personality. It develops in situations where reality does not coincide with a person’s desires and a discrepancy arises between the expected and the actual.

The purpose of the tantrum – protest, provocation, attracting attention, obtaining personal gain, manipulating others.
Hysteria occurs more often in children under 5 years of age, which is associated with age characteristics nervous system and inability to control emotions. In adults, tantrums are more common among women. In men, this type of behavior occurs 10 times less often.

Forms of hysteria

• Hysterical behavior– when interacting with others, a person often demonstrates the following personality traits:

• ostentatious emotionality;
• exaggerated experiences;
• suggestibility;
• tendency to deceit;
• flight into illness, when mental experiences are transformed into physical suffering;
• desire for parental care or guardianship by a partner/spouse.

As a result, a person’s behavior looks unnatural and inappropriate to the situation.

• Hysterical attack- an acute emotional reaction, a surge of feelings that a person demonstrates, although he does not experience them to the same extent. It manifests itself in crying, screaming, wringing of hands...

People with hysterical personality type. This character is formed when a child grows up to be the idol of the family, but subconsciously feels that the praise of loved ones is not deserved. According to psychoanalysis, the reason for the formation hysterical type personality – “betrayal” of a parent of the opposite sex. The parent begins to pay less attention to the child and reacts to him only when he is upset and shows it violently. This model of behavior is perceived by the child as the most effective and, having matured, he continues to use it.

Hysterical behavior and tantrums make a person “difficult” to communicate with. They may have more serious consequences: family destruction, hysterical personality disorder, suicide attempts. In this regard, it is necessary to take measures to correct hysterical behavior.

Why does hysteria occur?

The tendency to hysterics is due to 3 factors:

• Education according to the “family idol” type, as well as cultivating demonstrative character traits in the child, encouraging “acting” and mannerisms;
• Congenital features nervous system;
• State of health, exhaustion after severe injuries and long-term illnesses.

Why does a person develop a hysterical attack? Scientists do not give a clear answer to this question. There are several theories:

• Hysteria is the displacement of a problem by emotions. A person sees a problem in front of him and tries to force it out of his psyche with a violent manifestation of emotions. The problem often remains unresolved.
• Hysteria is an attempt to manipulate other people., attract attention, make them do what they want. With the help of a hysterical attack, a child or adult tries to achieve what he wants. And if he succeeded once, the hysterics will be repeated. They will become established as a model of behavior and will be used in various situations.

A hysterical attack can be triggered by:

• refusal of others to fulfill a desire or request;
• lack of attention or respect;
• refusal of a request or an unpleasant phrase;
• long-term sexual dissatisfaction;
• jealousy;
• hormonal imbalances during PMS, pregnancy and menopause;
• prolonged nervous tension, stress;
• robot in night shift;
• chronic fatigue caused by mental and physical activity. This reason can cause hysterics in a strong-willed person who is not prone to hysterical behavior.

The development of hysteria in women is facilitated by lack of professional fulfillment. This type of behavior is more common among housewives who devote all their time to family and everyday life. Melancholy, lack of social life, lack of impressions and attention from the husband provoke hysterical attacks. Their goal is to evoke sympathy or a feeling of guilt in the husband, playing on which the woman tries to achieve what she wants.
Hysteria in men is not a common occurrence. The basis of a hysterical attack is also an attempt to manipulate loved ones. Less commonly, the cause may be nervous exhaustion when there is no resource to solve the problem constructively.

What are the symptoms of tantrums in children?

A child’s tantrum is an attempt to attract the attention of parents or to get the desired thing (a toy, sweets, watching a cartoon).

A hysterical attack in children has clear manifestations:

1. Loud crying. It can be theatrical, with sniffling and eye-rolling, sometimes without tears.
2. Scream. The child moans, screams, shouts out individual phrases.
3. Redness of the facial skin. Less commonly, the face turns pale or blue.
4. Falling to the floor. Less often, the child lowers himself slowly and theatrically to avoid hitting himself. He rolls on the floor, punches and kicks.
5. Hysterical Bridge. The child falls to the floor, arches, resting on the top of his head and heels.
6. The child scratches himself with his nails, bites his hands, pulls out his hair, and tears his clothes.
7. After a seizure, the child quickly calms down, especially if he gets what he wanted.

Autonomic disorders during hysteria in a child are caused by changes in the functioning of the autonomic nervous system, which controls internal organs:

1. Vomiting caused by stomach spasms;
2. Stopping breathing (in children under 3 years of age) is a sign of increased nervous excitability leading to spasm of the larynx;
3. Trembling in the body;
4. Drooling that occurs with spasm of the muscles of the larynx;
5. Urinary incontinence – due to spasm bladder and temporary loss of control over it.

Distinctive feature of a hysterical attack– after this, the child’s condition quickly returns to normal: the mood improves, autonomic symptoms disappear. This is especially noticeable if the child managed to achieve what he wanted.
The symptoms of a hysterical attack intensify significantly if there are people nearby who are sensitive to the child’s behavior and make concessions. Without an “audience,” the hysteria quickly stops. The child does not experience the depth of feelings that he demonstrates. On the contrary, children with a hysterical type of character endure troubles quite easily, and their mood quickly changes to the opposite.
It is important not to confuse a child's tantrum with an epileptic seizure. Call a doctor immediately if the following symptoms appear:

• Sharp fall;
• Loss of consciousness;
• Foaming from the mouth;
• Convulsions are erratic movements that gradually intensify and turn into sharp, rhythmic bending of the limbs;
• After a seizure, the child feels very tired, does not remember what happened, and falls asleep.

What are the symptoms of hysteria in an adult?

Symptoms of hysteria in an adult appear only when there are people nearby whom he intends to influence.

External manifestations of a hysterical attack:

1. Screaming, accusations, threats.
2. Crying out loud, often without tears with closed eyes.
3. Shouting out individual sounds and words. Repeating the same phrases.
4. Erratic movements. Hand wringing, foot stomping, face scratching, hair pulling, teeth grinding. The movements are convulsive and theatrical, while the person does not cause significant harm to himself.
5. Falling to the floor. He does this consciously and carefully enough so as not to injure himself.

Autonomic disorders:

1. Vomiting caused by stomach spasms;
2. Swallowing disorders associated with spasm of the muscles of the larynx and esophagus;
3. Spasm of the larynx, accompanied by a feeling of suffocation;
4. Frequent urination;
5. Body trembling - hands tremble, chin trembles;
6. Temporary loss of function. According to the person, he loses the ability to hear, see, smell and taste, and feels numbness in half of his body. These disorders develop against the background full health all organs and nervous system. Often a person exhibits exactly the symptoms that in his understanding should be associated with an illness.

The disorders are associated with a malfunction of the autonomic nervous system and self-hypnosis. At the same time, a person is so susceptible to self-hypnosis that he really feels what he says.
The hysteria lasts as long as the audience is willing to pay attention. After an attack, a person cannot thoroughly remember what he said and what he did, but his consciousness is completely preserved. He calms down quite quickly. Your well-being improves significantly, especially if those around you have made concessions.

Remember that the following symptoms never occur during a hysterical attack:

• foaming from the mouth;
• tongue biting;
• painful head impacts;
• persistent requests to administer a certain drug;
• involuntary bowel movements and urinary incontinence;
• disturbance of consciousness;
• lack of pupillary reaction to light;
• deep sleep immediately after the attack.

These signs are characteristic of withdrawal syndrome (withdrawal), epileptic seizure or stroke. If at least one of them appears, you must call an ambulance.

Which doctor should I contact if my child has frequent tantrums?

If a child over 5 years of age experiences frequent tantrums, a consultation with a child psychologist or psychotherapist is recommended. He will conduct a diagnosis, determine whether there is a disorder, and, if necessary, draw up a psychocorrection program (conversations, games, exercises). will give advice to parents on how to behave during a tantrum
If a child's tantrums are accompanied by autonomic disorders(respiratory arrest, sweating, rapid heartbeat), then you need to contact a pediatric neurologist for examination.

How to correct behavior in a child prone to hysterics?

In the vast majority of cases, tantrums in a child are a passing phenomenon. Prevention of hysterics is based on changing the approach to education. Parents and grandparents must realize that if after a hysteria the child gets what he wants, then the hysterical attack will soon recur. It is important that they are united in their desire to teach the child to behave “like an adult” - to ask, negotiate, wait. If no one close to you succumbs to the child’s provocations, the hysterics will disappear in 2-4 weeks. Otherwise, even after reaching adulthood, the child will throw tantrums in front of a person who is sensitive to them.

Each child needs an individual approach, but there are general recommendations How to behave when a child is hysterical:

• Behave calmly and reservedly. A child's tantrum should not drive you crazy. It is important not to become overly affectionate or shouting.
• Impossible requests must be rejected firmly and calmly. Explain the reason using convincing arguments.
• Pause. Don't rush to your baby at the first sign of crying. The lack of an audience in your face may make him stop his hysterics. If this does not happen, go up to the child and say in a calm voice: “I see that you are upset now. We'll talk when you calm down."
• Ask for help:“I can’t figure out what you want. Help me, explain everything in detail.” This way you teach your child to express his feelings and desires in words and to look for a constructive solution to the problem.
• Ask to listen:“You have spoken, now it’s my turn...” Remember that you need to be as brief as possible. “I heard you. I will do what is best..."
• Offer a compromise:“Let’s agree with you like this...” If possible, make a concession. For example, “We will buy a doll after payday” or “Chocolate can be eaten after dinner.”

Child psychologists offer a simple method based on positive reinforcement:

• During a tantrum, do not pay attention to the child, do not talk to him until the attack stops. But don't leave the premises.
• As soon as the child is silent, approach and greet talk to the baby. Don't agree to his demands. But if possible, offer an alternative.
• If your child starts screaming or crying again, move away from him. him and stop communicating.

Thus, good behavior is reinforced by good attitude. The thought is deposited in the child’s mind: “As long as I behave well, they will be affectionate and attentive to me. When I scream, they don’t notice me.”

Children often throw tantrums in public places. This happens because there are many temptations and there are interested spectators. It is inconvenient for parents to ignore their child’s bad behavior in front of strangers; moreover, they often interfere in what is happening, playing into his hands. To wean a child from hysterics, parents must adhere to the chosen model of education both at home and in public places.

Remember that a child or teenager's tantrums will stop if he regularly encounters situations where hysterical behavior does not bring results. Indulging in whims aggravates the situation and can reinforce tantrums as a pattern of behavior in adulthood.

Is there any medication to prevent tantrums in children?

Mentally healthy child does not require medication to prevent hysterics. There are no specific medications that can prevent hysteria.
To reduce general nervous excitability you can use:

• mint tea;
• lemon balm tea;
• chamomile tea.

Despite the safety of herbal medicine, before starting it is better to check with your doctor about the dosage and contraindications.
Homeopathic medicines are prescribed exclusively by a neurologist or pediatrician. They do not “cure” hysterics, but improve the functioning of the nervous system, increase resistance to stress, and speed up falling asleep:

• notta;
• dormikind;
• Nervohel.

How to help an adult with hysterics?

• Create a calm environment. If possible, remove interested spectators. Give the person some time alone.
• Spray your face, neck, and hands with cold water. Offer to drink water and wash your face.
• Lightly pat your face and hands. Sharp blows can worsen the condition and cause a new attack of hysteria.
• Do an act that a person does not expect - wrap yourself in a blanket and drink.
• Give a cotton swab soaked in vinegar or ammonia a sniff. Strong smell affects receptors and certain areas of the brain and becomes a distraction.
• Don't communicate with him. If these measures do not work, then do not talk to the screaming person. Appear indifferent and go about your business.

If a hysterical attack developed after a person made impossible demands, then it is necessary to firmly and calmly refuse. Indulging in whims only makes the situation worse. Hysterics become more frequent, and neurosis may develop against this background.

The use of tranquilizers and antipsychotics is permissible only if a psychiatrist has diagnosed a hysterical disorder. Healthy people with a hysterical type of character, combined sedatives on a natural basis:

• persen forte;
• novo-passit;
• phytosed;
• valocordin;
• adonis brom.

Should an adult see a psychiatrist after a hysterical attack?

After hysterical attack, especially a single one, there is no need to consult a doctor if the condition improves within 10-30 minutes.

It is necessary to consult a psychiatrist if signs appear hysterical disorder personalities. Its symptoms appear constantly, and not from time to time:

• Constant desire to be the center of attention, regardless of the situation and environment (in line, in public transport).
• Infantilism– “childish” behavior pattern – capriciousness, laziness, excessive emotionality.
• Mood instability. Pictured outbursts of fun or hysteria that always occur in the presence of spectators. Left alone with himself, a person reacts more calmly to similar situations.
• Pathological fantasy– a person systematically invents facts to embellish himself or slander another.
• Conspicuous suicide attempts– a person may take a handful of pills in front of spectators or threaten to throw himself out of a window.

What treatment is prescribed for patients with frequent tantrums?

Hysterical behavior is easily corrected. Medications are not prescribed to people with a hysterical character. Treatment is based on psychotherapy and self-help measures. If you wish, you can get rid of hysterics in 1-2 months. For this it is recommended:

• Maintaining a rest and sleep schedule. It is necessary to go to bed and wake up at the same time, devoting at least 7 hours to sleep. While working or studying, you should take breaks, alternating mental activity with physical activity.
• Elimination of traumatic situations- quarrels, conflicts, noisy entertainment, watching thrillers and horror films.
• Normalization of hormonal state with the help of medications. The level of sex hormones in a woman significantly affects her emotional state. A gynecologist-endocrinologist prescribes treatment to normalize estrogen levels.
• Regular sex life. Sexual release helps normalize hormone levels. It also improves the neurochemical processes occurring in the nervous system and helps reduce nervous tension.
• Increased self-esteem:

• Stop comparing yourself to others. It is acceptable to compare your present self with your past self;
• Repeat positive statements towards yourself;
• Make a list of your strengths and achievements;
• Selflessly help others every day without talking about it;
• Get a job that brings you pleasure;
• Make decisions on your own, without seeking the approval of others.

• Alternative discharge methods:

• Sports – tennis, cycling;
• Dancing;
• Physical work(in the garden).

• Mastering relaxation skills:

• yoga;
• meditation;
• auto-training.

• Changing the attitude towards what is happening. Tantrums occur when expectations do not match reality. Therefore, you should not expect much from people and upcoming events, so as not to be disappointed.

Even if a psychiatrist has diagnosed hysterical personality disorder, the basis of treatment is psychotherapy. The doctor prescribes neuroleptics or tranquilizers only when signs of depression appear.

“Well, I threw a tantrum again!” " How much hysteria can you have? " Isn’t it possible to avoid hysterics?” " What a hysterical person you are! It’s simply impossible with you.” This can sometimes be heard when two people are trying to find some kind of solution to a problem, and then one of them becomes too emotional and breaks down into a scream that turns into sobs. What is hysteria, and how is this concept related to hysteria? What are the causes, signs and symptoms of tantrums? And most importantly - what to do about it? How to deal with tantrums? What is the difference between hysterics and hysterics?An article by psychotherapist Valery Belyanin about this

Hysterics and hysterics

Hysterics and hysterics

There are many similar words in the language:economical, economical, thrifty; bloody, bloody, bloody . Such words are called paronyms and despite all the similarities, they still differ from each other. Paronyms include the wordshysteria, hysteria, hysteria and hysteria . They differ terminologically.

Hysterical attack(colloquially “hysteria”) is a temporary state, hysteria – psychosomatic illness or a form of neurosis, and hysteria- character property. A hysteric (hysterical) is a person who throws hysterics (again, this is a colloquial word), and a hysteric (which is more scientific) is a person prone to hysterical reactions.

If we are talking about personality, then it is more correct to talk about “hysterical”. Here's what the American Psychiatric Association Dictionary says:

Hysterical personality disorder characterized by long-term (rather than episodic) types of behavior that consist of self-dramatization, when individuals attract attention to themselves, strive for activity and excitement, overreact to minor events, experience, and are prone to manipulative suicide threats and gestures. Such individuals appear to others as superficial, self-centered, disregarding others, vain, demanding, dependent and helpless. This disorder was previously called histrionic personality disorder..

Hysterical neurosis

As a rule, hysterical neuroses (hysteria) occurs in people who believe that they are somewhat unusual. Indeed, they are characterized by egocentrism, demonstrative behavior, mood swings, increased emotional excitability. In addition, these people have high suggestibility and self-hypnosis. That is why, even if the disease began with the goal of manipulating others, then, as a result, the patient actually feels a number of painful symptoms. Over time, this reaction is fixed at the level.

The cause of hysteria counts availability in a person's life traumatic situations both long-term and situational.

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Hysterical attack

Hysterical attack(colloquially hysterics) can occur in completely different people under the influence of circumstances that are difficult for them to overcome. A single seizure does not make a person “hysterical.”

A one-time hysteria should not be confused with such psychosomatic manifestations, such as hysterical blindness, hysterical deafness, numbness of the legs, etc.

Symptoms of a tantrum

Hysterical symptoms are very diverse. More often they appear infit of hysteria. Usually these are attacks of convulsive crying, sometimes turning into laughter, but usually ending in screams and manifesting themselves throughout the body (the so-called “motor storm” - Kretschmer’s term).

Severe hysteriamay result in a fall to the floor or convulsions. These convulsions quite successfully copy epileptic seizures, but they are characterized by a lesser degree of darkening of consciousness, a longer duration of the seizure, disorder and theatricality of movements.

A sign of hysteriaThere may be a sharply changing emotional state and behavior of a person who finds himself in a difficult situation, but cannot rationally approach its solution.

What to do when you are hysterical?

What should you do if someone close to you is hysterical?When hysteria unfolds before your eyes, it can be difficult to understand what is in front of you:

• staging?
• strange behavior?
• Is the person really feeling bad?
• or is the person doing everything to annoy you?

When observing a hysteria, it is very difficult to get rid of the thought that the person is “hysterical” on purpose to get his way or to scare you away from talking about the problem.

• Help a person come to his senses

When hysterical, a person has difficulty controlling himself, so you need to try to help him “come to his senses” - offer a glass of water, valerian, ask him to calm down.

• Don't persuade

If you begin to persuade a person, calm him down or feel sorry for him, then you will begin to act in the field of his coordinates, where only he will set the direction of communication. However, when a person is hysterical, there is little that can calm him down; it is difficult to reason with him. In a state of hysteria, a person is almost not affected by logic. It is better to remain calm and speak less.

• Leave the premises

If you stay nearby, you will play the role of the audience, for the sake of which the entire “performance” is played out. Therefore, it is better to leave and wait until the attack is over.

• Try to help again

If you think the situation is getting out of control, you can try using very small physical pressure: splashing water on the person, lightly patting the cheeks, lightly pressing on the painful pointon the arm just below the elbow pit.When the seizure is over, offer the person a glass of cold water or let them smell ammonia.

• Talk

After a hysteria, talk to the person, tell him that you cannot cope with such actions (there is no need to generalize to behavior, much less character) and suggest seeking help from a doctor, psychiatrist, psychologist, or psychotherapist. Just do it very gently, without aggression and without “getting personal.”

What is the cause of hysteria

The question is what is hysteria,and why it arises has been practically solved in psychology. Also J.-P. Sartre in his work “Essay on the Theory of Emotions” (1939) calls hysteria negative behavior, noting that it aimed at denying the urgency of problems and replacing them with others. He wrote that an emotional breakdown during hysteria is an evasion of responsibility . Hysteria is preceded by a "magical exaggeration of the difficulties of the world" , he writes. “The world... appears... as unfair and hostile”. And the choice that a person makes when indulging in hysterics is not the choice of an adult, it is choosing to remain a child.

A child has a tantrum

Why do some children like to throw tantrums, while others can control their emotions? There is no clear answer to this question. Perhaps the parents contributed to this by naming the girl Cleopatra and the boy Leopold (just kidding). You can still notice that from childhood, some children have a desire to show off, dress brightly, and attract attention with an unusual state, a whim.

But if a whim turns into hysteria, then this occurs:

• screaming, crying;
• the child hits his head against the wall or rolls on the floor;
• scratches the face;
• he experiences convulsions, his body bends (“hysterical bridge”).

Causes of hysteria in children

Why does a child have a tantrum? Hysterics do not arise out of nowhere. It just seems like they start unexpectedly. In fact, a child who is prone to tantrums does not know how to control his emotions; his momentary desires require immediate fulfillment; he does not always know how to express his needs verbally.

Frequent manifestations of any behavior can shape a person's character, making him less balanced and more accentuated.Accentuation of characterassumes increasing the degree of certain personality traits– wrote the German psychiatrist Karl Leogard (1904-1988). This is not psychopathology yet, but close to it.

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Hysterical teenager

Ernst Kretschmer (1888-1964) believed that many of the traits characteristic of hysterical personalities are lingering remnants of the psyche of the period of the onset of puberty (15-16 years), which, under the influence of unfavorable circumstances, were subjected to pathological change. And these changes are very specific: the contrast of idealistic tension love feeling and sexual coldness, a quick outbreak of feelings and its easy attenuation. They can be expressed in love for everything bright and exaggerated; this can be theatrical pathos, the desire to play brilliant roles, and dreams of great goals.

In its extreme manifestationshysterical girl or hysterical boycan play with suicide, dreamily striving to sacrifice himself. Often this is combined with naive childish egoism, when adults become “enemy number one.”

Hysterics are called both adult children and “adult adolescents” who have experienced a delay in biological development.

Hysteroid woman

Researchers note that hysteria is much more common in women than in men. In his extreme manifestation hysterical women are infantile, their thinking is situational and emotional, it is tied to a recent event.

Such women are suggestible, they are easily persuaded and uncritically accept the position of an authoritative interlocutor. They do not know how to be distracted from the situation, they depend on momentary experiences.

Hysterical type of man

There is an idea that hysteria is a feature primarily feminine character. However, there are oftenmale hysterics. Who are they?

A hysterical man can be impressive and elegant or sloppy. He may know a lot, may be an avid collector, speak deliberately loudly or deliberately very quietly. In any case, his task is to attract attention.

A hysterical woman's clothes include a lot of jewelry (large beads, clips, bows, headbands, bright ribbons); they wear bright clothes even in old age. Preference is often given to white.

For men, a means of attracting attention can be a cigarette holder, cigarettes, a smoking pipe with tobacco in a pouch (instead of a cigarette), a chain or even a pendant, a ring, a hat, a white scarf, a threaded cane, a bright jacket, a badge, etc. They often wear a mustache.

The body of an adult, according to the observations of psychoanalyst V. Zhikarentsov, “looks seductive”: “This is both a child and a woman at the same time, who calls, lures and seduces at the same time. This is a child's body on a feminine-shaped lower part. There is a split between the upper and lower halves: upper part- hard and restraining, and the lower one - soft and yielding. In the upper part of the body there is a powerful block - a defense that makes the heart impenetrable. The movements are rolling, soft, seductive. Such a person holds his head straight and proud. The jaw is firm and determined. The face may be motionless and lifeless. The eyes are scared and wide open (both literally and figuratively).”

Older people are hysterical

The behavior of an elderly person can also be hysterical. He may dress inappropriately for his age, have frivolous conversations, and flirt with younger people. The behavior of older people is difficult to correct. They've been used to doing things a certain way their entire lives, and age-related changes make them insensitive to the reactions of other people due to special senile selfishness.

Speech of hysterical personalities

In the speech of persons with hysterical accentuation, what attracts attention is not so much the content as the form. Hysteroids speak exaggeratedly loudly, with expression, with acting skills. Their speech can be shrill and shrill. They often speak quickly, as if they are afraid that they will not be allowed to finish their sentences. At the same time, they like to interrupt their interlocutor. They “capture” the space of communication; their solo part becomes the main one. At the same time, they do not always know how to coherently express their own views, since their speech is subject to associations, emotions, and not the laws of logic. And they may not have their own view of the problem. If there is one’s own position, then it is paradoxical or shocking in nature and contains numerous accusations and insults. Analysis and assessment of events is replaced by a discussion of the persons participating in them.

The outrageousness of men can manifest itself in conversations on obscene topics, with vulgarities and rudeness, which are spoken with enough with a serious look. The function of their speech is a challenge, an insult, a provocation.

There are exceptions when a hysterical personality, usually a man, with a good memory, bombards his interlocutor with facts and data gleaned from non-standard sources in order to show how everyone is wrong, and how only he is right.

Hysterical men often have pauses in their speech, their gaze sometimes stops after what has been said: as if they were waiting for the effect that their words were supposed to produce.

The abundance of gestures, facial expressions and body movements is accompanied by a special intonation: it is intermittent, with a rise in every word (especially in women). It should also be noted how very characteristic feature– laughter of a hysterical personality. It is sharp, explosive, hoarse. Quite often he accompanies his own joke.

The mannerisms of hysteroids

Hysterical behavior is characterized by theatricality, deliberateness, the desire to present committed actions in a favorable light, attribute non-existent advantages to oneself, and simply invent spectacular events in which the narrator plays the main, often heroic role. A tendency to fantasize and fabricate is also often found with a hysterical character.

Any opportunity to mention his acquaintance with a celebrity is important to the hysteroid, which gives him great pleasure.

Lies of hysterics

Psephologists and pathological liars are close to hysterical personalities, who have, “on the one hand, an overly excitable, rich and immature fantasy, and, on the other, pronounced moral defects,” wrote psychiatrist P.B. Gannushkin (1875-1933).

A lie is a deliberate distortion of the real state of affairs. This is one of the ways to mislead people around you to achieve your own goals. Hysteroids can so sincerely believe in what they say, in their own inventions and illusions, that some authors consider it incorrect to call hysterical behavior insincere. Hysteroids are very sincere in their delusions. The hysterical, realizing that his actions create tension, cannot always abandon the chosen form of behavior, defending his fictions and fantasies with painful persistence.

V.V. Znakov notes that “turning to the analysis of the psychological mechanisms of lying, it should often be considered as external manifestation personal protective mechanisms aimed at eliminating feelings of anxiety and discomfort caused by the subject’s dissatisfaction with his relationships with others.”

Hysteroid and love

Almost all people are subject to love. Hysteroids are perhaps the most loving representatives of the human race. They quickly “break out”, fall passionately in love, sincerely suffer, and also passionately hate.

Marriage to a hysteroid is not always easy. On the one hand, he can be a good master, and she can be a mistress. On the other hand, solving many ordinary problems can turn into a performance.

Hysteria in creativity

In light of the above, it will not be unexpected to observe that hysterical people prefer activities related to the world of art. Theatre, cinema, exhibitions, operetta, fashion, design attract just such people.

Since hysterical personalities are characterized by deceit, the desire to attract attention in every possible way, the thirst for recognition, and artistry, this makes the field of art for them the most acceptable niche of activity.

According to the German psychiatrist Karl Leonhard, there are many descriptions of hysterical personalities in fiction. He includes many of F.M.'s characters among them. Dostoevsky: Klikusha, Fyodor Pavlovich Smerdyakov (“The Brothers Karamazov”), Lebedev (“The Idiot”), Porfiry Petrovich (“Crime and Punishment”). There are many of them in world literature: Tartuffe (J.B. Molière “Thiriof”), Luzman (Lope de Vega “Luzman”), Felix Krul (T. Mann “Confessions of the Adventurer Felix Krul”), Dorant (P. Corneille “The Liar” "), Emperor Nero (Sienkiewicz “Quo vadis?”), Fiesco (F. Schiller “The Figsco Conspiracy in Genoa”), a number of characters from ancient Greek authors (Sophocles, Aeschylus, Euripides, Plautus). He believes that fiction replete with demonstrative personalities.

This may be due not only to the fact that such “characters” exist in our lives, but also to the fact that writers have a hysterical streak. For example, the German novelist Karl May claimed that he personally knew the hero of his novels, Winnetou, a noble Indian (Leonhard, 1981).

Hysteria manifests itself, according to our observations, most often in such genres as musicals (operetta) and TV series such as “soap operas”. Perhaps someone else remembers the series “Slave Isaura,” which is based on the novel by the 19th century Brazilian writer Guimarães.Here's how the runaway slave is described:“From the estate of Senor Leoncio Gomes de Fonesca, municipal district of Campos, province of Rio de Janeiro, a slave named Isaura fled with the following characteristics: light skin color, gentle face like any white woman, black and large eyes, hair the same colors, long, slightly curly, mouth small, pink, beautifully outlined, teeth snow-white and even, straight nose, thin waist, slender figure, average height. Small on the left cheek black mole, over right breast- a burn mark, very similar to a butterfly wing. He dresses tastefully and elegantly, sings well and plays the piano masterfully. Since she received an excellent education and has a good figure, anywhere she can pass for a free lady from a good society.”Note that this is the text of an advertisement that Leoncio placed in a local newspaper about his runaway slave.

Neuropsychological

Model of the world of a hysterical personality

Speaking of features life path, it can be noted that a hysterical personality describes his life as full of humiliation, betrayal, squabbles, oppression and failures. In the perception of one's life as humiliating, there are contradictory cognitive attitudes of the hysteric: “I want to be the center of attention” and “I deserve contempt”, “I am worthy of adoration.” This brings them closer to narcissistic personalities

That is why it is so typical for hysterical personalities to explicitly or indirectly emphasize their merits (real or fictitious). Men may casually mention their connections with the “powers that be” or with people who move in the “world of art”; they love to talk about their material or physical capabilities, and even about paranormal abilities. Women love to inadvertently demonstrate the advantages of their figure, emphasizing it with clothes or decorating themselves. If those around you do not notice these signals, or - even worse - ignore them, then this can cause irritation in the hysteroid; he (or she) will avoid contact with people who do not sufficiently appreciate them, their exclusivity and originality. At the same time, they can demonstratively break off the relationship by saying something like:

“To be honest, I thought you were all like that.” And it turns out you have no idea.

“At first it seemed to me that we found a common language, but it turns out that you are a dishonest person.” I don't want to know you.

Or here’s how the hero of N. Gogol’s story “Dead Souls” Nozdryov expresses himself:

- Eh, Chichikov, why should you come? Really, you're a sucker for this, you cattle breeder! Kiss me, soul, death love you!

- I bet you're lying!

- However, it’s a shame! What am I really? Why do I have to lie?

- Well, yes, I know you: you are a big swindler, let me tell you this out of friendship! If I were your boss, I would hang you from the first tree.

It is important for the one who is rejected to understand what conclusions he can draw from the communication, what was actually wrong and what was “incriminated.”

Hysterical personality disorder

How to help a hysteroid

Helping a hysterical person is not easy. Firstly, he rarely asks for help. And treatment without a request causes resistance in any person. Secondly, the help must be professional.

Hysterical neurosis or hysteria is one of the forms of a psychopathological disorder characterized by a wide variety of manifestations. Hysteria is characterized by motor and affective disorders, increased suggestibility and demonstrativeness – the main distinguishing feature all manifestations of the disease. During a hysterical attack, patients may cry, scream, laugh, they experience disturbances in heartbeat, breathing, convulsive seizures, temporary paralysis, blindness, deafness or loss of consciousness may develop.

Hysterical neurosis or hysteria is a disease known since ancient times; it was first described and studied by the ancient Greeks, who considered this disease to be exclusively female, and developing due to “rabies of the uterus” (from another gr. hystera - uterus).

In the Middle Ages, both female and male representatives suffered from hysteria; almost all patients belonged to the upper classes, and the disease itself was considered “aristocratic.” In the 19th and 20th centuries, hysteria was often refused to be recognized as a disease, considering attacks to be a sign of “bad upbringing,” “spoiledness,” and the reason for their development was an excess of free time.

Modern medicine has proven that hysterical neurosis is a mental illness, but its development requires certain conditions and a certain character of the patient. Almost always, hysterical manifestations are demonstrative; spectators are required for their occurrence, and the patient himself is characterized by increased emotionality, egocentrism, and is easily suggestible.

Due to the instability and increased emotionality of women, female hysteria occurs several times more often than male hysteria, which is diagnosed quite rarely.

Causes of hysteria

What is meant by hysterical neurosis? This is the most severe manifestation of the disease, which is characterized by regular and severe attacks of hysteria, with convulsive seizures, loss of consciousness, attacks of suffocation and other manifestations.

This condition occurs when a person with a certain character is exposed to a severe psychotraumatic factor. In the development of the disease, risk factors and predisposing factors are distinguished.

Risk factors include:

• loss or illness of a loved one;
• life-threatening situation;
• problems in personal life;
• loss of work, money, other material assets;
• quarrel, conflict with someone;
• any other stressful situation.

Predisposing factors for the development of hysteria include lifestyle and a certain type of human character.

Symptoms of hysteria

U hysterical neurosis There are no specific symptoms or characteristic manifestations. This disease can “hide” behind the symptoms of any somatic disorder. According to some experts, during hysteria the source in the brain that is responsible for a certain function in the body is temporarily “switched off” and it is impossible to accurately predict what exactly may be affected.

There are 3 main groups of symptoms:

• movement disorders;
• psychoemotional disorders;
• vegetative disorders.

Movement disorders

With hysterical neurosis, they can be observed as minor deviations from normal: nervous tic, twitching, trembling in the limbs, heaviness in the arms and legs, weakness, loss of muscle activity, and serious pathologies, up to hysterical paralysis and complete loss of control over motor functions.

Most often, the patient experiences hyperkinesis of the extremities: arms and legs may twitch involuntarily, the head begins to tremble, and a nervous tic appears. As the seizure progresses, convulsive twitching may develop, patients fall to the ground, have convulsions, cannot speak, and lose consciousness.

Less commonly, hysterical paralysis occurs - the patient suddenly “loses” one or both limbs, he cannot move his arms or legs, and loses the ability to move or do anything.

Hysterical neurosis is characterized by complete preservation physical condition the patient and the absence of pathologies from the osteoarticular and nervous systems.

Psycho-emotional disorders

With hysterical neurosis, patients most often experience phantom pain - in absolutely any part of the body, loss of sensitivity, speech impairment, stuttering, feelings of heat, cold, general malaise, and so on. In the most severe cases, temporary impairment of vision, hearing and speech may occur, up to complete deafness, blindness and muteness.

A change in the psycho-emotional state of the hysterical person is characteristic. All hysterical attacks occur only in the presence of spectators, and the reason for their development, as a rule, is any situation in which the patient cannot get what he wants or is forced to do something.

In an attack of hysteria, patients strive to attract as much attention to themselves as possible, scream, cry loudly, fall to the ground (and do this carefully enough so as not to harm themselves), may begin to tear their clothes or use any other methods to attract the attention of others. people.

In the absence of such attention, hysteria can deepen, turn into seizure or cause the development of any physical disorder.

Autonomic disorders

Disturbances in the functioning of the autonomic system can manifest themselves as any signs of somatic diseases. As a rule, there are several groups of such characteristic symptoms:

1. Throat neurosis. Patients have a feeling of “a lump in the throat”, they cannot swallow or speak, a spasm of the larynx develops, there may be a feeling of lack of air, fear of suffocation. With this type of hysterics, the person grabs his throat with his hand, tries to say something, begins to choke, panics and may lose consciousness.
2. Neurosis of the respiratory system. This type is characterized by complaints of shortness of breath, lack of air; patients suddenly begin to choke, gasp for air, try to breathe, cough and turn pale from lack of oxygen.
3. Neurosis cardiovascular system. Palpitations, chest pain, increased blood pressure, headaches and loss of consciousness occur.
4. Neurosis of the gastrointestinal system. Manifested by nausea, vomiting, abdominal pain and indigestion.
5. General violations. Increased sweating, tremors, dizziness, fainting, itching and redness of the skin.

How does a doctor make a diagnosis?

Establishing a diagnosis of “hysterical neurosis” is not always quite simple, especially if the patients themselves are convinced and persistently convince others of the presence of severe somatic disease. Manifestations of hysterical neurosis can be mistaken for diseases of the cardiovascular, nervous system, vegetative-vascular disorders and other pathologies.

You can suspect manifestations of hysterical neurosis, and not other diseases, by the following signs:

To confirm the diagnosis and exclude other pathologies, additional research methods are prescribed: general and biochemical blood tests, urine tests, EEG, ECG, ultrasound of internal organs, cerebral vessels, and, if necessary, MRI and CT scan of the brain. They also provide consultations with a neurologist, cardiologist,.

Treatment

When treating hysterical neurosis, the doctor almost always encounters active or passive resistance from the patient, who refuses to admit that he has a similar disease, suspects others of treating him poorly, and the doctor of incompetence.

It is very important, at the same time as taking medications, to begin treatment for hysterical neurosis with a psychotherapist, who should help the patient accept the situation and, together with a specialist, find ways to solve the problem. Equally important is changing the patient’s lifestyle, looking for opportunities to express and demonstrate their emotions, find an outlet for excess energy, and so on.

Drug treatment

For the treatment of hysterical attacks, sedatives and sleeping pills, less often - neuroleptics and antidepressants.

Most often used:

Psychotherapy

Treatment with a psychotherapist is most effective when initial stages diseases when they have not yet had time to form somatic manifestations disease, while therapy for a long-term disease requires a lot of time and great professionalism of the doctor. Most patients with hysterical neurosis refuse the help of a psychotherapist or try to convince him of their illness.

A specialist in such a situation should, without focusing on the patient’s complaints, try to help him find the causes of the conflict and ways to resolve it. The most common treatments used are hypnotherapy, cognitive-behavioral and mediation psychotherapy.

It is very important to change the lifestyle of a patient with hysterical neurosis, adherence to a daily routine, regular physical activity, sports, mandatory walks. fresh air, good sleep And proper nutrition help restore and strengthen the nervous system, get rid of negative emotions, improve health.

For a person suffering from hysteria, it is very important to find something that helps him cope with emotions and not suppress them, but express them in some way. This could be dancing, playing sports, singing, drawing or any other activity that the patient enjoys.

The name of the disease hysteria comes from the Greek. “uterus”, since in ancient times hysterical disorders were associated with a disease of the female genital area, in particular the uterus, which was attributed the ability to wander around the body, block the airways and disrupt important vital functions. This view is completely wrong and has now been abandoned by everyone, but the old name of the disease has been preserved.

Causes of hysteria

The origin of hysteria is most often associated with mental trauma, but infections, intoxications, exhaustion, physical trauma and other factors that create an acquired predisposition to hysteria also play a certain role here. Particular attention should be paid to the etiological significance of shortcomings in upbringing and unfavorable social relationships. The share of exogenous and endogenous causes etiology varies sharply. Their relationship is inversely proportional: the more pronounced the predisposition to illness, the less the role of mental trauma, and vice versa, in people who are mildly neuropathic or psychopathic, only affective experiences of great strength can cause corresponding disorders.

The role of mental trauma is very important. Nervous shock may be associated with external or internal conflict. The mental factor plays such a large role in the etiology and pathogenesis of neurosis, in the origin and construction of the symptoms of the disease, that all authors consider hysteria as an example of psychogenicism.

Unreasonable upbringing plays a role in the development of hysteria. Every healthy child, and even more so nervously and mentally unstable children, needs systematic educational influence from family and school. The absence of such rational, healthy influence from elders or harmful influence on the child: indulging his whims, pampering, instilling egocentrism, the belief that he can do anything, that he is not like other children, but better than them, that he is at the center of the family’s life, that everyone is obliged to please him, he is not has no responsibilities - contribute to the development of a hysterical character, which forms the background against which the symptoms of hysteria appear.

“Public relations are the final authority that shapes hysteria” (Sepp). This statement is certainly true. Social relations influence the maturation of the character of each person, determine the content of his mental life, the volume of requirements placed on it by the real situation. The mental trauma that causes hysteria is the product of a certain social environment. Looking ahead a little, we can say that social relations influence not only the origin, but also the structure of hysterical psychoneurosis, its pathoplasty.

It is appropriate to note that previous authors, as well as a number of modern foreign researchers, saw only one side (biological or psychological) in the complex structure of hysterical pathology. Dejerine assigned the main role in the origin of hysterical disorders to pathological efficiency. Kraepelin believed that phylogenetically ancient things are resurrected in hysterical reactions defense mechanisms that hysterical symptoms are distorted forms of normal emotions: hysterical vomiting is a manifestation of disgust, hysterical mutism or trembling is a manifestation of fear.

Kretschmer viewed hysteria as an abnormal form of reaction to the demands of life, as a “flight into illness” from difficulties, as a “tendentious neurosis” that arises in connection with the presence of a “will to illness.” “The revelation of a certain direction of will in the depiction of illness is what particularly appeals to us as a hysterical phenomenon,” wrote Bongeffer.

According to I.P. Pavlov, hysteria arises due to a breakdown nervous activity in people with a weak nervous system, in whom the first signaling system predominates over the second alarm system. Patients with hysteria in most cases belong to the artistic type: figurative-emotional thinking prevails over rational-abstract thinking.

People with a strong type of nervous system can also get hysteria, but this happens rarely, only under the influence of a large overstrain of higher nervous activity for a long time, under the influence of especially severe factors that traumatize the psyche. This type of disorder is mostly treatable. Many clinicians in similar cases prefer to talk about hysterical reactions.

Hysteria can be caused by trauma to the skull (especially often), some organic diseases of the central nervous system, and exhaustion. Main etiological factor, there is always a mental experience that leads to a breakdown of higher nervous activity.

Symptoms of hysteria

The symptoms of the disease are extremely varied. The disease can cause disorders of varying nature and severity in the motor, sensory, vegetative-trophic and mental spheres.

With hysteria, paralysis and paresis may be observed, reminiscent in some cases of central, spastic paralysis, in others - peripheral, flaccid. They can be localized in different areas of the body. Most often, hysterical monoplegia (arms), hemiplegia or hysterical lower paraparesis is observed. Less common is paralysis of the tongue, neck and other muscles.

A common occurrence is hysterical contractures, which most often affect the joints of the limbs, but can also be localized in the spine, neck (hysterical torticollis) or face (spasm of the orbicularis oculi muscle). Hysterical paralysis and contracture may disappear during sleep.

Gait disorders are often observed. The best known is hysterical astasia-abasia, i.e. the psychogenic inability to stand and walk. There may be no weakness of the legs with this syndrome: while lying in bed, the patient performs all movements well with her legs; Only certain functions are lost - standing, walking. Astasia-abasia is often combined with hysterical paresis of the legs.

Hysterical convulsive attack. Charcot distinguished four phases (or periods) in a hysterical attack: 1) epileltoid convulsions; 2) big movements, or clownism; 3) passionate poses; 4) hallucinatory-delusional. The large hysterical attacks described by Charcot are now very rare.

Typically, hysterical attacks occur as a reaction to emotional excitement. The attack begins with palpitations, a feeling of lack of air, a feeling of a ball in the throat (giobushystericus). The patient falls, convulsions appear, which can be tonic, clonic and tonic-clonic. Opisthotonus and “hysterical arc” are often observed. The eyes are usually closed. The pupils react to light. During a seizure, patients often tear their clothes, hit their heads, moan, and sometimes shout out some words or call someone. In some patients, a seizure is preceded by crying or laughter.

More often there are minor hysterical attacks, which mostly proceed like this: feeling a palpitation, a knot in the throat, the patient sits down. She has difficulty breathing. The face turns red (more often) or turns pale. She makes a series of random movements with her hands. This is often accompanied by crying and laughter.

Sensitivity disorders during hysteria are a common occurrence. Both the distribution of skin hyperesthesia and the degree of decreased sensitivity in patients with hysteria can be extremely varied. Most often, hemihypesthesia is observed, less often - parahypesthesia, monohypesthesia. There is also often hyperesthesia. Hysterical pain can resemble real neuralgia. The classic pain symptom is clavushystericus - sharp pain in one place, sort of like from a driven nail. What is characteristic of hysterical sensitivity disorders is that they are located not in accordance with the anatomical distribution of sensory nerves and roots, but with the patient’s naive ideas about the distribution of functions and the localization of the disease process. Particularly typical is hemihypesthesia with a border running strictly along midline, or hypoesthesia with an “amputation border” on the limb.

Symptoms from the sensory organs. More often than other disorders, there is a concentric narrowing of the visual field, sometimes hysterical blindness, which in most cases passes quickly. Hysterical deafness affects mostly one ear.

Speech disorders in hysteria are often observed. This includes hysterical muteness or deaf-muteness, stuttering, and hysterical chanting of speech. Closely related to them is hysterical aphonia.

Violation of the activity of internal organs. Patients suffering from hysteria often complain of poor appetite, swallowing disorder, spasm of the esophagus, which is based on spasm of the muscles of the larynx and esophagus, instability of the cardiovascular system, hypersalivation or, conversely, dry mouth, pollakiuria or rare urination. Psychogenic vomiting, yawning, hysterical diaphragm spasm, and hysterical cough are sometimes observed. Hysterical flatulence can cause the phenomenon false pregnancy. Often there is a weakening of sexual desire - sexual coldness, less often - more serious deviations.

The features of the mental organization of patients with hysteria deserve great attention, since it is they, forming the hysterical character, that form the basis of this psychoneurosis. The patient has character traits: egocentrism, desire to be the center of attention, increased emotionality, irritability, emotional lability, mood swings, tearfulness, increased suggestibility and self-hypnosis, thirst for new experiences, painful fantasy, pseudo-realization of one’s ideas, a tendency to aggravate one’s painful disorders.

The behavior of patients with hysteria is characterized by demonstrativeness, theatricality, and is devoid of simplicity and naturalness. Such patients are impulsive, extravagant, and express their emotions in forms unusual for an adult. There is much that is immature and infantile in the mental appearance and behavior of the patient. His attitude towards his illness is very peculiar. A doctor observing a patient with hysteria often gets the impression that the patient is happy with her illness and does not want to recover.

Diagnosis of hysteria

Recognition of hysteria is based on the psychogenic development of the disease in direct connection with mental experience, the presence of clinical symptoms characteristic of hysteria, and the absence of signs of organic disease.

There are, however, cases of hysteria, the diagnosis of which is fraught with great difficulties. This especially applies to hystero-somatic syndromes, which can very “successfully” simulate organic damage to the nervous system. Experienced clinicians sometimes make mistakes in such cases. An incorrect diagnosis can only be prevented by a thorough examination of the patient, taking into account his somatic and mental organization, behavioral characteristics, anamnestic data, the dynamics of individual symptoms and the entire process as a whole, as well as the everyday environment and social factors in a broad sense words. Repeated examination and inpatient observation are often required. In the most complicated cases, the diagnosis is established with certainty based on the results of treatment: a significant improvement in symptoms (and even more so, disappearance) under the influence of direct or indirect psychotherapy indicates their psychogenic nature.

When observing patients with hysteria (as well as with patients with neurosis in general), it is necessary to remember the possibility of an organic disease in a person with a neuropathic (hysterical) constitution. In such cases, there is a double danger: behind the bright picture of neurosis, one may not discern organic suffering or, on the contrary, attribute organic process everything that is found in the patient, including hysterical symptoms. An error in both cases can lead the treatment down the wrong path. Overestimation of the hysterical moment and underestimation of organic matter is especially dangerous, since this may result in lost time for successful therapy.

It must be remembered that some organic nervous diseases often complicated by pseudoneurotic symptoms - mental instability, irritability and even demonstrativeness. Such diseases include multiple sclerosis, encephalitis, cysticercosis, brain tumors and abscesses, cerebral injuries, atherosclerosis, .

Sometimes hysterical reactions are observed in sufferers initial forms mental illnesses - schizophrenia or manic-depressive psychosis.

Hysteria usually appears for the first time in adolescence or even adolescence and proceeds chronically, exacerbating under the influence of various negative aspects and passing into a latent state under favorable conditions. With age, hysterical character traits and clinical manifestations of neurosis, for the most part, are somewhat smoothed out. The menopausal period often temporarily aggravates painful disorders. Hysteria can, however, occur in childhood and in older people. Heaviness individual cases extremely different. A neurological examination reveals a significant uniform increase in tendon reflexes, a neurotic reaction to inducing reflexes (general shuddering, groans, sometimes tears), trembling of the fingers and eyelids, instability in the Romberg position, symptoms of dysfunction of the autonomic nervous system, features of a hysterical character are revealed from the anamnesis, typical manifestations hysterical psychoneurosis in the past (in childhood or adolescence), a tendency to psychogenic disorders and mental trauma that caused the latest exacerbation of neurosis. With treatment, the exacerbation goes away, and the patient (usually the patient) again feels satisfactory, without seeing a doctor for years. Less common are more severe forms, in which patients are often forced to lie in bed for weeks.

Prognosis for hysteria

Hysterical reactions can be treated well if the patient manages to free himself from the situation that caused them, and much worse, sometimes very badly, if the situation cannot be changed.

It is easier to count on a complete cure of hysteria in young subjects who do not have much “hysterical experience” and are accessible to educational influence. However, life also influences mature patients with hysteria, dulling their effectiveness, forcing them to inhibit - consciously or subconsciously - their inherent hysterical mechanisms and thus promoting their treatment.

Treatment of hysteria

The main role belongs to psychotherapy. Most often used rational therapy according to DuBois. In more severe cases, hypnosis in combination with explanation may be used.

Hysterical monosymptoms (so-called hystero-somatic disorders) are successfully treated with electrosuggestive therapy.

Along with psychotherapy, restorative, physiotherapeutic and drug treatment. A big role belongs correct regimen and regular work. Giving patients with hysteria long-term vacations does not contribute to their cure.

The article was prepared and edited by: surgeon