Hysterical paralysis refers to various forms of loss of mobility of the upper and lower limbs that are present in certain patients, without any indication of a direct neurological cause.
Even before the Studies on Hysteria (1895d), the problems that hysterical paralysis posed to the medical diagnostic model led Freud to introduce the first elements of psychoanalysis in a work called “Comparative Study of Organic and Hysterical Motor Paralysis” (1893c) .
For Freud, hysterical paralysis seems very precisely delimited in relation to its “excessive intensity” (1893c, p. 164), and seemed to be more related to the way patients imagined their bodies than to any distribution of lesions in real anatomy. Based on the fact that peripheral points of the body are grouped at the level of the nerves that represent the medullary centers of the cortex, Freud’s neurological conception of “representation paralysis” went far beyond Charcot (1880-1893) called a “Illness of representation.” Freud was looking for “permission to move into psychological terrain” (1893c, p. 170), and he crossed that border based on the difference between organ and function.
This value also corresponded to the placing of paralysis at the level of representing both fantasy and action. When defining hysterical paralysis of the arm as “the abolition of associative accessibility of the conception of the arm” (1893c, p. 170), he raised both the issue of trauma and the affective value of a function, so he anticipated what later it would be known as associative bonds and breaks, isolation and repression .
We also see here that what would later become the “innervation” of the repressed idea – “psychic excitement that takes a wrong turn”, as Freud wrote in 1894 (1950a, p. 195) – does not restrict the notion of conversion to an idea single discharge, but it settles within conflicting ambivalence, and this if muscle contraction, paralysis, or anesthesia were involved. Thus, the symptom reaches the repression of representation and the return of affection related to its original condition, as an innocent action. This disconnect between affection and symptom is what Charcot called the “ belle indifférence ” of hysterics (cf. Freud, 1915d, p. 155-56).
Thus conversion occupies a precise position between hypochondria, which aims to mentalize the unrepresentable depths of the interior of the body, and, for other extreme psychosomatic disorders, when somatic improvement or recovery dispenses with the symbolic level entirely. Between the two, the conversion involves the striated musculature in order to play out a drama at the level closest to the body. The involvement of the vegetative level is not excluded here, as long as it is introduced into a fantasy, the desire that is expressed in its negative form as paralysis (Jeanneau, 1985).