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Sidebar 3.5 Culture and Hysteria

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The evolution of the definition of hysteria led to the clinical conceptualization of somatoform, conversion, dissociative identity, and amnestic disorders. The diagnosis of these disorders is culture bound, and the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) addresses this directly in a distinct section, “Culture-Related Diagnostic Issues,” which helps counselors diagnose syndromes in an appropriate cultural context. For example, ataque de nervios comprises a constellation of symptoms that would have been analogous to a diagnosis of hysteria in 1890. In Hispanic culture, this is interpreted as an “intense emotional upset, including acute anxiety, anger, or grief; screaming and shouting uncontrollably; attacks of crying; trembling; heat in the chest rising into the head; and becoming verbally and physically aggressive” (p. 833) or otherwise feeling out of control.

Counseling and Psychotherapy

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