Jean-Martin Charcot’s spectacular studies of hysteria drew crowds to his Tuesday lectures in turn of the century Paris and they remain an enduring subject of fascination today. Vision and visuality were central to how Charcot made sense of the disease and how he made a name for himself. The photographs taken of his star patients published in the Iconographie photographique de la Salpêtrière in the 1870s, including those of Alice Winocour’s eponymous film Augustine, are at once disturbing and beautiful. André Brouillet’s 1887 “A Lesson at the Salpêtrière,” featuring the “queen of the hysterics” Maria “Blanche” Wittman captures the gendered dynamics of the institution’s scopophilic regime. A copy of it famously hung in Sigmund Freud’s office.
Wittman is at the visual center of the painting: she is unconscious and prone, with her bodice open and sunlight reflecting off her chest. Under Charcot’s orchestration and interpretation, her contracted body is given over to the epistemological, professional, and sexual desires of identically suited scientific men. A public asylum for women with a long and notorious past, the Salpêtrière institutionalized the gender and class relations of power upon which Charcot capitalized in advancing his career.
Charcot became famous for making sense of a chaotic disease, a “wastepaper basket” of symptoms that resisted stable classifications and etiologies. By outlining four distinct phases of “grand hysteria”– the tonic, clonic, passionate attitudes, and delirium– he stabilized the diagnosis. Attributing its causes to a “diffuse functional lesion” of the nervous system, Charcot focused attention on his patients’ spectacularly visible symptoms: spasms and crises, paralysis and anesthesia, exaggerated emotions and hallucinatory fantasies. Using photography and hypnosis, Charcot and his associates documented and reproduced this series of symptoms, provoking crises with bright lights and loud sounds, prodding bodies, applying electric current and administering ether, transcribing the patients’ fantasies and deliria. The proposed cures relied on many of the same intense and intimate technologies: hypnotism, electrotherapy, magnetism, and ovarian compression.
Charcot, his assistants, and patients themselves regularly used mechanical ovarian compressors to stop and prevent attacks. The device and other technical details feature in Alice Winocour’s dramatic recreation of Augustine’s life at the Salpêtrière. In this rendering, Charcot sadistically– and unsuccessfully– applies it in order to cure her of her paralysis. At various moments in the film, Charcot traces hysterogenic zones on Augustine’s naked body, prods her with prongs, pierces her arm with a long needle in order to test the extent of her anesthesia (she lost all sense on the right side of her body). A scene that appears to recreate Brouillet’s painting features Augustine (played by the pop star Soko) in a white bodice appearing before an audience of men. Charcot (played by Vincent Lindon) presents her as suffering from “ovarian hysteria.” When she is hypnotized before the assembled onlookers, Augustine’s feathered hat quivers (another detail drawn from the records of Charcot’s performances). The attack then worsens and she falls to the floor in an orgasmic delirium. Charcot may have denied the uterine origins of hysteria, but the film intimates here and throughout that there is something unmistakably sexual going on.
The question of hysteria’s relation to sex is indeed foregrounded in Winocour’s film. In a scene at one of Dr. and Mme Charcot’s famous evening gatherings, a young colleague asks the master: “If it’s in the brain, why is their delirium always sexual?” Charcot deliberately asserts: “It’s not part of the disease. It’s just the delirium.” The conversation echoes that overheard by Sigmund Freud when he attended a similar gathering at Charcot’s, during his Paris sojourn in 1885-86. Referring to a case of a married couple in which the husband was impotent, Charcot responded to his student Brouardel: “in such cases, it is always the genital thing” [la chose génitale], always . . . always . . .always.” Freud wondered at the time “‘Well, but if he knows that, why does he never say so?’” For Foucault, of course, such denegation barely masked how the Salpêtrière was “a machinery for incitement.”
The Iconographie photographique, produced under the auspices of the hospital by D.M. Bourneville and P. Regnard, captured some of this sexual subtext in transcriptions of the patients’ deliria and in accounts of their personal histories. In Winocour’s film, a young doctor recounts one such scene to Charcot in which Augustine lasciviously called out to her imaginary lover, much as she does in one of Bourneville’s accounts of her période de délire. In the previous scene Augustine and her doctor were shown playing flirtatiously with his pet monkey (another detail drawn from Charcot’s real life). He appears to be clearly troubled by the building tension between them. The dynamics of transference and countertransference are beginning to escape the master’s control.
The film’s narrative then builds towards its climax: Augustine will appear in a presentation before members of the Academy of Science to which Charcot hopes to be elected. The doctor/patient couple takes long walks in the mist-filled grounds of the hospital, while she expresses frustration at his refusal to listen– signaling the dramatic difference between Charcot’s methods and those subsequently developed by Freud. The important day approaches. As attendants do a final fitting of Augustine’s blue satin dress, she escapes only to fall down a set of stairs: the shock cures her paralysis. She is healed just before she is scheduled to appear, with Charcot’s career depending on a flawless performance. Once in the amphitheater she refuses to fall under the doctor’s hypnotic spell– only to simulate a perfect attack once he has become resigned to the demonstration’s failure. She is now the one in control. This public reversal is followed by a private one. Back in his office, it is Augustine who initiates the fulfillment of their mutual sexual fantasy. This literal and figurative climax clears the way for her liberation. Augustine escapes the asylum, leaving Charcot with the knowledge that his election to the Academy will be based on her charade.
Augustine, whose real name was Louise Augustine Gleizes, really did refuse to be hypnotized by Charcot and soon after escaped the Salpêtrière in 1880, disguised in men’s clothing. But the amphitheater scene and the seduction are clearly Winocour’s imaginative creation. They demonstrate how the film uses historical details in order to weave together a historical fiction– or fantasy. Like dream work, it uses historical residues in order to create something new, which can be understood as revealing, if not strictly speaking real. For example, Charcot was elected to the Academy of Sciences in 1883, several years after Augustine left. And while the transcripts in the Iconographie indeed detail Augustine (and other patients’) sexualized deliria, the sexual relation between the patient and the doctor is fictional. As the director explains in an interview added to the film’s region 1 DVD, the plot is based on “true facts.” But at the same time, she tried to “distance [herself] from the historical background, in order to tell a timeless story about desire.” Students will no doubt want to interrogate the “timeless” conception of desire depicted here. The film hence raises questions about the historical contingency of maladies and their treatment but also about the complex dynamics of power in doctor/patient relationships as well as intersubjectivity, feminism, and fantasy.
The film might thus be integrated into a broader discussion about gender, sex, illness, and agency as well as the relationship between psychoanalysis and history, including what is at stake in fantasmatic retellings of the past. These issues are in many ways highlighted by the film’s departure from the historical record, even as it reworks its residues. In order to engage productively with these questions, however, students will need another account of Charcot and his patient. A highly accessible and engaging discussion of Charcot’s star patients can be found in Asti Hustvedt’s Medical Muses. It provides a lucid overview of Charcot’s career, with separate chapters devoted to three of his best known patients: Blanche Wittman, Augustine, and Geneviève Basile Legrand. Hustvedt’s text is also interested in telling a story of the Salpétrière as much as possible from the perspective of the patients as from that of the doctors’. It is also revisionist in its more sympathetic treatment of the doctors themselves, and especially of D.M. Bourneville who was responsible for detailing much of Augustine’s life both before and during her stay at the Salpétrière. Hustvedt argues that Bourneville really did listen to the patients, carefully recording their physical as well as mental suffering.
Hustvedt’s chapter on Augustine provides an extended discussion of one of the factual details that is notably absent from Winocour’s film: the sexual assaults she suffered at the hands of an employer with whom she was placed by her mother at age thirteen. The details of her rape feature in the Iconographie and are summarized by Hustvedt as an implicit, if not explicit, traumatic cause of the attacks that she soon after began to suffer. In Winocour’s film, by contrast, the proximate cause or trigger for Augustine’s episodes feature in the opening scene: the sight of crabs, trapped in a pot of boiling water, struggling for their lives. (The animal motif persists throughout the film, with the monkey’s presence and Charcot’s reference in his final lecture to the difficulty of performing experiments on “animals.” In her interview, Winocour repeatedly describes Charcot’s patients as having been treated like “guinea pigs.”) The film does not, however, treat this history of sexual abuse and it has Augustine enter the Salpêtrière at age nineteen, while, in fact, she was fourteen when she began her stay. These changes and omissions obviously complicate the film’s narrative. They make the already troubling character of Charcot and Augustine’s erotic relationship even more disturbing. They unsettle the film’s account of how Augustine achieves (sexual) liberation.
Georges Didi-Huberman’s The Invention of Hysteria is another possible pairing. While drawing extensively on the Iconographie and Charcot’s writings, Didi-Huberman’s text is less narrative than Hustvedt’s and more interested in understanding the various technologies, at once psychic and material, that “produced” hysteria at the Salpétrière. As an art critic and historian, Didi-Huberman focuses his attention on the role of photography in Charcot’s project. This question of visual technology and indeed the protocinematic character of the Salpêtrière’s iconography is, however, largely absent from Winocour’s film. While it explicitly cites many of the famous images of Augustine, photography is marginal to the film’s story. (Indeed, it mistakenly suggests that photographs were taken during Charcot’s lectures, when they were in fact produced in a studio.)
By contrast, Jean-Claude Monod and Jean-Christophe Valtat’s beautiful short film from 2003, also titled Augustine, foregrounds what is missing from Winocour’s. Filmed in an exquisite black and white that echoes the quality and character of Augustine’s poses in the Iconographie, this film stresses the protocinematic and protopsychoanalytic dimensions of the story. (The film’s opening images of a horse running with the sound of a projector turning suggest Eadweard Muybridge’s contemporaneous photographic sequences). The story of sexual violence is also present. When Bourneville mentions Augustine’s rape, Charcot responds: “it’s always the genital thing.” And the scenes of delirium cited in the film refer directly to Augustine’s efforts to resist rape and her relations with a boyfriend she called Emile. Like Winocour’s this film’s narrative is structured around Augustine’s escape, but here it is the eroticized connection that she establishes with a young hospital assistant rather than Charcot that allows her to make her disguised exit. The ambivalent relationship between doctors and their patients nonetheless also figures prominently. In one scene, Bourneville hypnotizes Augustine, commanding her to “fall in love with and waltz with him.” Charcot dreams of being able to “make and unmake [her] crises at will.” Augustine suspects the equivocal pleasures that the “cochons de docteurs” derive from their manipulations and orchestrations. And we also see Augustine refusing to be hypnotized by Charcot. In this film’s fantasmatic closure, Augustine escapes into the arms of her waiting boyfriend, Emile.
If Winocour’s film is a conventional costume drama, Monod and Valtat’s film is explicitly self-referential in its scripting and cinematography. Because the film is neither subtitled, nor available (yet) on publicly released DVD, it is not well suited to classroom use. But it will definitely be rewarding to specialists and motivated students who might want to track it down.
Together both of these efforts to reimagine life at the Salpêtrière from the perspective of one of Charcot’s “stars” capture significant elements of historical context and period detail. In translating those aspects into fictions, they get at many of the issues that continue to make Charcot’s hysterics puzzling and disturbing today. What was the relationship between knowledge and pleasure in this and other institutions? How should we think about the complex of power relations between doctors and patients? What and whose desires are fulfilled by retelling the story of Augustine’s eventual escape?
Alice Winocour, Director, Augustine, Color, 2012, 102 min., France, Dharamsala, France 3 Cinéma, ARP Sélection
Jean-Claude Monod, Jean-Christophe Valtat, Directors, Black and White, 2003, 43 min., France, Les Films du Possible, Centre National de la Cinématographie (CNC), Conseil Régional d’Auvergne.
- On Charles Lasègue’s characterization, see: Jan Ellen Goldstein, Console and classify: the French psychiatric profession in the nineteenth century (Cambridge and New York: Cambridge University Press, 1987), 324.
- Sigmund Freud and Philip Rieff, The History of the psychoanalytic movement : and other papers, The Collected papers of Sigmund Freud (New York: Collier Books, 1972), 12.
- Michel Foucault, The History of Sexuality, (New York: Vintage Books, 1980), 55.
- Paul Regnard and Désiré Magloire Bourneville, Iconographie photographique de la Salpêtrière (service de M. Charcot), par Bourneville et P. Regnard, vol. 2 (Paris: bureaux du “Progrès médical”, 1878), 162. For students interested in consulting the original, it is available as a Google book.
- For a recent effort to address these questions with respect to Charcot, Freud, and a number of their contemporaries, see: M. Brady Brower, “Science, Seduction, and the Lure of Reality in Third Republic France,” History of the Present 1, no. 2 (2011). Jan Goldstein’s presentation of the earlier case of Nanette Leroux through a simultaneously Foucauldian and Freudian lens is similarly provocative. Jan Goldstein, Alexandre-Jacques-Francois Bertrand, and Charles-Humbert-Antoine Despine, Hysteria complicated by ecstasy : the case of Nanette Leroux (Princeton: Princeton University Press, 2010).
- Asti Hustvedt, Medical Muses : Hysteria in Nineteenth-Century Paris, 1st ed.(New York: W.W. Norton & Co., 2011).
- Regnard and Bourneville, Iconographie photographique de la Salpêtrière (service de M. Charcot), par Bourneville et P. Regnard, 2, 127. Hustvedt, Medical Muses,152.
- Georges Didi-Huberman and J. M. Charcot, Invention of hysteria : Charcot and the photographic iconography of the Salpêtrière (Cambridge, Mass.: MIT Press, 2003).
- A version of the trailer and a slightly longer excerpt are available online.