1. Culture
   1. Neuron recently isolated
   2. Complexity of brain just beginning to be understood
2. Freud's Training
   1. Graduated medical school
   2. Started as a researcher
   3. Clinical practice started
      1. Needed money
      2. Started on Easter
   4. Charcot
      1. Ideas can cause symptoms
      2. Problems not in the flesh
         1. Problems in an idea
         2. Ideas outside of awareness
      3. Ideas can bring temporary cures
3. Hysteria
   1. Considered common and chronic in women
   2. Hysterics
      1. Suffered from physical disabilities
      2. Evidenced no obvious physical impairment
   3. Considered by doctors of the time as
      1. Malingerers
      2. Morally suspect fakers
      3. Generally weakened nervous system
      4. Symptoms
         1. Random
         2. Meaningless
   4. History of Diagnosis
      1. First diagnosed in at least 4th century BC
      2. APA dropped diagnosis in 1952
      3. Ancient, medieval, Renaissance, and modern medical authorities before Freud characterized hysteria as a collection of "vague and sexually focused" symptoms
         1. chronic arousal
         2. anxiety
         3. sleeplessness
         4. irritability
         5. nervousness
         6. erotic fantasy
         7. sensations of heaviness in the abdomen
         8. lower pelvic edema
         9. vaginal lubrication
   5. History of Treatment
      1. First Century AD & Earlier
         1. Hippocritic corpus
         2. Celsus
      2. 17th Century
         1. Pieter van Foreest (1653)
            1. When these symptoms indicate, we think it necessary to ask a midwife to assist, so that she can massage the genitalia with one finger inside, using oil of lilies, musk root, crocus, or [something] similar. And in this way the afflicted woman can be aroused to the paroxysm. This kind of stimulation with the finger is recommended by Galen and Avicenna, among others, most especially for widows, those who live chaste lives, and female religious, as Gradus [Ferrari da Gradi] proposes; it is less often recommended for very young women, public women, or married women, for whom it is a better remedy to engage in intercourse with their spouses.
      3. 19th Century
         1. Pinel
         2. Gall
         3. Tripier
         4. Briquet
   6. Freud's Diagnosis
      1. Disease of mind not of brain
      2. Ideas, not nerves, are the origins of problems
         1. Disturbing ideas connected to a stressful event
         2. Not remembered by the patient
      3. "Hysteria was caused by trapped memories and the feelings associated with them"
         1. Memories and feelings never processed normally
         2. Split off from the rest of the mind
         3. Fester and rise to the surface as troubling and "seemingly inexplicable" symptoms
      4. Content of the memories and feeling
         1. Disturbing
         2. Unacceptable
         3. In conflict with the rest of the person's ideas and feelings
         4. "incompatible with the rest of consciousness and were themselves actively kept out of awareness"
      5. "Whereas Breuer saw hysterics as people susceptible to altered states of consciousness, to being 'spaced out,' Freud saw hysterics as people rent with conflicts and harboring secrests, from themselves as well as from others."
   7. Freud's Treatment
      1. Hypnosis
         1. Breuer
            1. Bertha Pappenheim
            2. Anna O.
            3. "chimney sweeping"
            4. "talking cure"
            5. Using hypnosis her associations lead back to origin of symptoms
            6. Origin connected to a disturbing and forgotten memory
            7. Talking leades to an emotional discharge
            8. Emotional discharge followed by symptoms disappearing