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J Neurol Neurosurg Psychiatry doi:10.1136/jnnp.2009.199158
  • Review

Dissociation in hysteria and hypnosis: evidence from cognitive neuroscience

  1. Quinton Deeley1
  1. 1Institute of Psychiatry, King's College London, London, UK
  2. 2Departamento de Psiquiatría, Universidad de Antioquia, Antioquia, Colombia
  3. 3Division of Psychology and Language Sciences, University College London, London, UK
  4. 4School of Psychology, Cardiff University, Cardiff, UK
  1. Correspondence to Dr Q Deeley, Institute of Psychiatry, King's College London, Box P050, De Crespigny Park, London SE5 8AF, UK; peter.q.deeley{at}kcl.ac.uk
  • Received 2 November 2009
  • Revised 17 August 2010
  • Accepted 18 August 2010
  • Published Online First 30 September 2010

Abstract

Jean-Martin Charcot proposed the radical hypothesis that similar brain processes were responsible for the unexplained neurological symptoms of ‘hysteria’, now typically diagnosed as ‘conversion disorder’ or ‘dissociative (conversion) disorder’, and the temporary effects of hypnosis. While this idea has been largely ignored, recent cognitive neuroscience studies indicate that (i) hypnotisability traits are associated with a tendency to develop dissociative symptoms in the sensorimotor domain; (ii) dissociative symptoms can be modelled with suggestions in highly hypnotisable subjects; and (iii) hypnotic phenomena engage brain processes similar to those seen in patients with symptoms of hysteria. One clear theme to emerge from the findings is that ‘symptom’ presentation, whether clinically diagnosed or simulated using hypnosis, is associated with increases in prefrontal cortex activity suggesting that intervention by the executive system in both automatic and voluntary cognitive processing is common to both hysteria and hypnosis. Nevertheless, while the recent literature provides some compelling leads into the understanding of these phenomena, the field still lacks well controlled systematically designed studies to give a clear insight into the neurocognitive processes underlying dissociation in both hysteria and hypnosis. The aim of this review is to provide an agenda for future research.

Footnotes

  • Funding The authors gratefully acknowledge the role of The Psychiatry Research Trust in funding research which has facilitated the writing of this review article.

  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.

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