The connection frequently made between trauma and mental disorder has its twentieth-century foundations in psychoanalytic theorising. In their first paper on hysteria, Breuer and Freud outlined a traumatic theory of the disorder, contending that the concept of traumatic hysteria — that is, hysteria provoked by some physical accident — could be extended to include hysteria provoked by a psychic event or series of events. Their delineation of the notion of trauma was broad and was formulated in terms of the reaction to certain events. A trauma was any experience provoking distressing affect, such as fright, anxiety, shame or physical pain. Consequently, the term potentially embraced a domain of experiences little different from that now encompassed by ‘stressful events’. However, their theoretical focus in analysing individual cases was more restricted, concentrating on sexual experiences and on the sexual dynamics of family relations. Of the five cases (all women) presented in Studies in Hysteria (Breuer and Freud 1974), only Breuer’s Anna O, whose hysteria was said to have its origins in the illness and death of her father, was not directly attributed to sexual trauma.
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