It's Different in Men

The Greeks had a word for it: "hysterics." They got the word from hystera, meaning womb, and they thought the trouble began when the womb strayed from its proper place. Naturally, they did not see how a man could have hysterics. Not until 2,000 years after Hippocrates did physicians suggest that hysteria (as the disorder came to be known) could occur in men, and even then they admitted it was rare. Now three psychiatrists who worked together in Boston have come to the conclusion that the Greeks were right the first time: what passes for hysteria in men is by no means the same as hysteria in women.

When Drs. Eli Robins and Mandel E. Cohen and the late Dr. James J. Purtell began their study, they thought it would be easy to find patients because their colleagues spoke of there being a few hysterical men in every hospital. This, it soon developed, was not so. The "hysterical" men actually had diseases ranging from epilepsy to cancer and poliomyelitis. In fact, for a long time the three researchers could find no men in a civilian hospital whose illness fitted the definition of hysteria. So they turned to military and veterans' hospitals.

In all, they found 38 men diagnosed as suffering from hysteria or, as it is sometimes called, "conversion reaction." They carefully checked these patients against healthy men, against men with physical illnesses, against other male neurotics and female hysterics. Their findings:

"Hysteria" in men differs from women's hysteria in one essential way: the men always stand to gain something, such as escape from prosecution or release from military service. They do not plan their illness deliberately for this purpose (if they did, it would be fraud or malingering), but the element of advantage is always present. None of the women patients stood to gain anything nearly so tangible from their hysteria, so far as the doctors could see.

Men patients can always describe their symptoms crisply, e.g., "I'm all nervous inside and pass out," or "I can't seem to remember things and I rave at night," and they know where they "hurt." Women hysteria patients, on the other hand, can never tell precisely what ails them: they babble vaguely and dramatically about aches & pains all over. And they commonly have twice as many symptoms as the men.

Drs. Robins and Cohen do not present their findings as final. Rather, they urge that data on "hysterical" men be kept separate from that on hysterical women. And if any physician finds a genuine case of old-fashioned hysteria in a man, they want to know about it.

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