On the Road

As the title declares, this is a book about reality. Or, more accurately, “reality.” Author of an impressive study of multiple personality (Rewriting the Soul, 1995), Professor Hacking here narrows down his interest in the extraordinary changeableness of mental symptoms to one circumscribed instance: a psychiatric epidemic of “hysterical fugues”—cases of people who suddenly left home, suffered from amnesia, and took on a new identity, at least for a while. Diagnoses of these cases began to be reported around 1886 and continued, says Hacking, for twenty-two years—then more or less disappeared.

Hysteria, of course, in the sense of a trancelike state that translated mental obsession into physical language, had been observed since the days of Hippocrates, and identified over time with diabolic possession, religious ecstasy, epilepsy, displaced womb, and any number of simulated illnesses. Its essence was that the patient dissociated feeling from conscious awareness—sent it on stage, so to speak, to act out its story. In the late nineteenth century, particularly under the aegis of the celebrated Parisian neurologist Charcot, it took weird and wonderful forms, which he tended to associate with epilepsy. At the same time, among the ordinary population, fainting and paroxysms and “vapors” were in fashion, mainly among women. These were in themselves a kind of fugue or flight; but as used by the psychiatrists cited by Hacking, fugue meant a literal flight out onto the road.

Hysterical fugues may not be everyone’s immediate first choice of subject, but Hacking tells an almost unputdownable story. Not only does he write with rare sympathy and elegance, he draws on his background in philosophy to make this byway from the history of medicine full of resonance. Were these bizarre mental illnesses, now apparently extinct, “real” ones? Are they in fact extinct, or just changed in shape? Within any one personality, can anything be discarded as unreal? What are the roles of awareness and memory in dividing up a personality? What was the popular effect of new knowledge of unconscious layers of personality? Did these discoveries influence patients’ symptoms—or vice versa? At the turn of the last century there was indeed a veritable rewriting of the soul going on, and it hardly seems finished yet. We may well feel nostalgia—a nostalgie de l’âme?—for the time when the soul was a single and sacred thing.

Albert Dadas, a semiliterate gas fitter of Bordeaux, probably concerned himself very little with the soul, though there was certainly some deep malaise within his own. Hacking has retrieved Albert’s case from a book brought out by Philippe Tissié, a Bordeaux psychiatrist, in 1887: Les Aliénés voyageurs. Mad Travelers‘ core is four lectures on Tissié’s case; these are supported by extensive notes and appendices. Hacking argues persuasively that dissociated wandering like Albert’s became a mental illness for a time, was found all over the place, and vanished when the intellectual climate became unsympathetic.

Albert was born in 1860 into an impoverished artisan family in …

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