A psychiatric parlance of sexual trauma is first attested in Breuer and Freud’s Studien über Hysterie (1895). Here the reifying expression carried divergent theoretical ambitions: Freud’s sexuelle Traumen referred to childhood experiences attaining ‘traumatic power’ as later memories (causing hysterical anxiety), while Breuer’s sexuale Traumen referred to anxieties and negative experiences commonly associated with female puberty (requiring repression) and the ‘sexual noxae’ of the marriage bed (causing hysterical somatic phenomena).Footnote 1 The initial reception of Freud’s intricate and increasingly specific sense of sexual harm (sexueller Schädlichkeit), developed in his later seduction papers, was famously icy but it gained epochal traction after the 1970s – meriting probes into its intellectual debtsFootnote 2 , and more broadly into nineteenth-century regard for the psychological sequelae of adverse sexual experience. This regard is generally recognised as having been poor.Footnote 3 Indeed: even by the mid-1920s, empirical interest in the specific plight of the sexual victim (Sexualopfer) had barely emerged alongside the by now much more discriminating focus on the sex offender (Sexualverbrecher, Sittlichkeitsverbrecher). This emergent polarity flattered law more than it did medical deliberation. Many of nineteenth-century sexuality’s pre-eminent malefactors – the onanist, invert and pervert – were themselves casualties; if not of seduction, then of chance impressions, social neglect or indulgence, addiction or compulsion, degeneration, hereditary or congenital anomalies, or some infaust combination of these.Footnote 4 Moreover, sexual victims and offenders historically converged on a similar historical turn inward of the medico-forensic gaze: from diagnostic probing of the affected body, to the soul-searching of the affected self. Both victims and offenders posed perennial questions of the relative import of experiential contingency and innate susceptibility in the causation of mental disorder. Elementary to modern constructions of sexuality and maturity, both became figurations variably of innocence and corruption. Inevitably, their respective extended moments of medical deciphering refer to similar, vital questions of biography, identity, memory and medical savoir.
To better appreciate how sexual experience became traumatic, below I map nineteenth-century etiological concerns for adverse sexual experience apropos a brief appraisal of Freud’s and Charles Féré’s mid-1890s accounts; identify various experiential stressors drawing psychiatric attention (illegitimate maternity, moral virginity, masturbation, sexual inversion/perversion); consider the becoming-psychiatric of the two main nineteenth-century sexual victims – minors and women; and close with a brief appraisal of criminal anthropologist Moriz Benedikt’s early victimology.
1 Innocence and Injury: Féré and Freud
The conceptual groundwork for Freud’s sexual trauma has been mapped in considerable detail. Accounts of traumatic neurasthenia (Beard), hystérie traumatique (Charcot) and traumatische Neurose (Oppenheim) offered in the 1880s, dividing Wilhelmine stakeholders over the issue of social insurance and the wartime fate of the nation, foregrounded the question of the relation between physical trauma and its affective reverberation.Footnote 5 To Freud and Breuer, Charcot’s specific allusions to autosuggestion and focus on male hysteria insinuated the possibility of a properly psychic trauma.Footnote 6 Freud went on to suspend trauma between psychosexual immaturity and maturity, intuitive concepts burdened with a late eighteenth-century, but still largely implicit, scientific urgency. Sexual adversities had gained little etiological profile at the Hôpital de la Salpêtrière (notoriously soFootnote 7 ), and Freud’s earliest allusions to childhood ‘sexual noxae’ drew no clear support from any literature. These allusions were, in their essence, commonsensical, referencing an extended archive of Enlightenment investments in innocence (Unschuld), puberty (Mannbarkeit) and moral-psychological development (moralische Entwicklung) – notions that had been fracturing the emergent concept of ‘sexuality’ and that sponsored a general frame for conceptualising developmental ‘harm’ and precocity. Leading Enlightenment educator Joachim Heinrich Campe (1746–1818) illustratively identified many purported harms (Schädlichkeit) of ‘premature’ education of children, including sexual and psychosexual precocity.Footnote 8 During the 1780s and 1790s, premature awakening of the sexual instinct presented a recurrent and urgent hygienic challenge to the figureheads of both the Philantropinists and the German public health (medicinische Polizey) movement. Seductive nursemaids were indicted in hundreds of texts following Tissot’s Tentamen de morbis ex manustupratione (1758), and the spectre of psychosexual untimeliness went on to inform various nineteenth-century aetiological questions. Precocity – in mental exertion, sexual excitement, puberty or marriage – was named a key factor in the development of hysteria throughout the nineteenth century, for instance.
Freud was hardly the first to connect troubled innocence with neurotic diathesis, then, nor was he alone, in the early 1890s, in giving psychosexual untimeliness a primary traumatogenic significance. In September 1894 Charcot’s pupil, Charles Féré (1852–1907), suggested that in some children, ‘surprised in the absolute placidity of innocence … a mere touch or the sight of something unforeseen occasions a trauma [traumatisme] which overthrows once and for all their intellectual and mental [moral] being’.Footnote 9 Other children, hereditarily or congenitally predisposed as expressed in their physiognomy and precocious appearance, rather ‘exert a particular attraction on the debauchees who come to meet them’. In Féré’s three case studies, early childhood unwanted sexual experiences presented ‘mental chocs’ (chocs moraux rather than chocs traumatiques; compare Charcot’s choc nerveux cérébrale), events initially interpreted as ‘infamy’ or experienced with ‘violent terror’, commonly to be followed by amnesia, with memories revived (ravivé) after childhood by unrelated stressors, and giving rise to episodes of melancholy, rumination, or, in a ‘heavily predisposed’ woman suffering from puerperal mania, suicide attempts.
Freud and Breuer were by this time gravitating toward a more intricate etiological circumscription of sexual innocence. In May 1895 Freud captured Katharina’s being approached by her father (‘uncle’) at age fourteen in terms of sexual trauma, elaborating that in comparable cases, he found hysteria invariably connected to ‘impressions from the pre-sexual period [vorsexuellen Zeit] which produced no effect on the child [but] attain traumatic power at a later date as memories, when the girl or married woman has acquired an understanding of sexual life’.Footnote 10 Another ‘sexual trauma’ Freud discovered in the childhood of a lady suffering from obsessions and phobias.Footnote 11 In the same work, Breuer briefly discussed a case indexed in the 1955 James Strachey translation as homosexual trauma: a twelve-year-old boy, accosted by a man for oral sex, presenting with anorexia. The boy’s conversion was tied to a complex of factors: his ‘innate neurotic nature, his severe fright, the irruption of sexuality in its crudest form into his childish temperament [Hereinbrechen des Sexualen in seiner brutalsten Form in das Kindergemüth] and, as the specifically determining factor, the idea of disgust’. His initial non-disclosure, finally, prevented excitation from ‘finding its normal outlet’.Footnote 12
Féré, Freud and Breuer were solving a similar puzzle: the legacy in mental suffering of the interplay of an early childhood ‘sexual scene’, its recollection and disclosure, and the scourge of disposition. As is well-known, Freud subsequently developed his etiological conception of Verführung (seduction) in letters to Wilhelm Fliess (dated 8, 15, 16 and 20 October and 2 November 1895), identifying childhood ‘sexual scenes’, present as unconscious memories, as a necessary component of an hysterical or obsessive-neurotic disposition. Some Sexualscenen notably differed from the scènes du viol (rape scenes) referred to in the French hysteria literature:Footnote 13 some events produced fear but others pleasure (jouissance), or entailed children’s ensnarement by seducers in a ‘regular love relationship … with its mental side developed’ – a ‘mutual dependence’. As for Féré, there was no clean break with predispositions even by 1896, however: the patient’s ‘inherited and personal constitution’ still weighed in.Footnote 14
Freud desisted from empirical and even theoretical inference at this point, thus arguably defusing most of his kernel conjecture: ‘what decides whether those [ie. precocious sexual] experiences produce conscious or unconscious memories—whether that is conditioned by the content of the experiences, or by the time at which they occur, or by later influences—that is a fresh problem, which we shall prudently avoid.’Footnote 15 The looming problem of a lacking sexual theory to account for repression was spelled out in ‘Draft K’ sent to Fliess on 1 January 1896, in which Freud initially considered, but then rejects, factors including shame (which he ties to gender) and moral sense (which he ties to social class). By January 1898 Freud deferred theory to Fliess’s teleology, though this hardly solved his questions: ‘It seems that in man the sexual instinctual forces are meant to be stored up so that, on their release at puberty, they may serve great cultural ends. (Wilh. Fliess.) Consideration of this sort may make it possible to understand why the sexual experiences of childhood are bound to have a pathogenic effect.’Footnote 16 Puberty’s seemingly critical extension to ‘adolescent’ development in 1895 – its psychological operationalisation in terms of a caesura in sexual knowledge and ‘moral sensibility’ – thus remained notably ambivalent. Freud’s seduction texts resorted back to Pubertät: harmless pubertal scenes (Pubertätsscenen: eigentlich harmlosen Pubertätserlebnissen) referred to noxious ‘presexual’ ones (Infantilscenen: Scene[n] aus der Kindheit), more specifically those before the second dentition.Footnote 17
How to appreciate Freud’s pertinent work historically remains as urgent as it remains challenging. Discussions of children’s appraisal of atypical early sexual encounters had hitherto lacked the combination of psychological focus, theoretical audaciousness and empirical backing. In forensic medical review, deliberations on the ‘development of the personality and the future morality of the child’ had been utterly sporadic and concise.Footnote 18 Discussions revolved only formulaically around children’s ‘purity’, ‘the first instincts of modesty’, ‘psychic-moral formation’ and concepts such as violence morale.Footnote 19 Child abuse, though commonly held to be the main cause of prepubertal hysteria around mid-century, had presented only a very rare occasion for formal considerations of psychotrauma.Footnote 20 Guilt, shame and the formation of a ‘sexual personality’ were culturally intuitive factors but became formal psychological projections only by the time of – and in part in response to – Freud’s Drei Abhandlungen zur Sexualtheorie (1905).Footnote 21 Negotiations of ‘sex shock’ in the first quarter of the twentieth century remained strongly oriented around qualifications of Freud’s consecutive theoretical nuances. The beginnings of an empirical sexual victimology of the legal minor were established at a guarded distance of psychoanalytic theory, such as emerging from William Stern’s psychology of legal testimonyFootnote 22 and mid-1920s studies of incest victims.Footnote 23 Psychoanalytic circumscriptions such as that of incest trauma followed well after Freud’s initial seduction theory, which had barely set apart sibling cases and notoriously obscured family ties between offenders and victims.Footnote 24 Most pre-eminent interwar psychiatrists and psychologists worried more about ‘homosexual seduction’ and girls’ ‘juvenile delinquency’ than about ‘trauma’. The early afterlife of Sexualtrauma made for protracted and divergent negotiations of ‘seduction’, then, all the more foregrounding the historical question of its initial intervention.Footnote 25
2 Moral Trauma: Hysterics, Mothers, Virgins, Onanists, Perverts
The toll of modern ‘sexuality’ (Geschlechtlichkeit, conjugality, amativeness) interested many psychiatrists during the early nineteenth century, and much of this interest foreshadows Breuer and Freud’s mid-1890s work. At mid-century any perceived threat to women’s socio-sexual role fulfilment was a predisposing factor in hysteria: ‘… abandonment after a lively and initially mutual love; separations too long and too frequent; domestic troubles that hurt the heart and the self-esteem of a sensitive woman (Louyer-Villermay). Jealousy, indecent assault [outrage fait à la pudeur], premature widowhood, continence, finally, have been regarded as the causes which, in the end, most often lead to hysteria.’Footnote 26 Amor infelix (unhappy love), amor deceptus (deceived love), amor recusatus (rejected love) and zelotypia (morbid jealousy in the amorous sphere) were frequently signalled out.Footnote 27 Chagrins d’amour, amour malheureux, and amour contrarié were ubiquitously tied to mania and lypemania (melancholy) as well.Footnote 28 In a 1847 biannual mental hospital report from Prague, ‘unhappy love, deluded hope and stuprum violentum’ was reported as a compounded ‘harmful influence’ in one case of melancholy; ‘unhappy love’ was documented in thirteen cases of mania and in four of anoia; ‘spurned love’ accounted for two cases of mania universalis.Footnote 29 In the context of religious mania, reports another author, ‘The explosion of delirium sometimes occurs as a result of sexual excesses or solitary abuse. But it results more readily from a mental trauma [traumatisme moral], a painful emotion, a thwarted love’.Footnote 30 Cited psychic stresses on the nervous system are reiterated throughout mid-century French and German legal medicine, with deceptions in the social-relational sphere, a wounded sense of honour (verletztes Ehrgefühl) and wounded pride (gekränkter Ehrgeiz) repeatedly named as causes for mental illness (hypochondria, melancholia), suicide or crime.Footnote 31
Respect for maternal mental coping and ‘sexual honour’ in relation to illegitimate births famously led Kant to pardon infanticidal mothers.Footnote 32 Out-of-wedlock expectant mothers, such as due to rape, were found ‘tortured by external and internal reproaches, by grief, sorrow and in general by depressing emotions’, threatening neonatal safety.Footnote 33 Thomas Arnold (1742–1816) knew ‘a young woman, who, being insane, in consequence of the terror occasioned by an attempt made upon her person, imagined that she was for ever bringing forth children, and had a fresh delivery almost every instant’.Footnote 34 Concern led to consistently formal social psychiatric conceptions of puerperal psychosis. In 1868 Krafft-Ebing highlighted
violent and pathological effects to be considered in dubious mental states of illegitimate birth-givers. Shame because of loss of sexual honour [Schaam über die verlorene Geschlechtsehre], anxiety about the future, the horror of the signs of approaching birth, especially when the pregnant woman, as it happens in rare cases, did not know she was pregnant, suddenly and powerfully affect the mother, the pregnancy with the grief over the misstep, the distress and despair when the seducer has left the lover – all these powerful psychic shocks not infrequently interact in the extramarital gravida and create conflicts in consciousness that not all can be resolved along the moral way, at least in a moment when the nervous system is exhausted and irritated by the pains of birth. It thus easily comes to higher degrees of affect, to the confusion of meaning, to despair.Footnote 35
This elaborate gendered regard for socio-sexual experience was ratified both by the mid-century affect-centred theory of hysteria by Robert Brudenell Carter, and the social epidemiological approach by, among others, Pierre Briquet. The precise import of sexual assault here was a function of the sense of moral calamity generally attributed to it, and highly sexed constructions of innate impressionability and sense of shame (pudeur).Footnote 36 The early modern essence of pudeur was its imminent violation – ‘incurable’ ‘injury of the heart’Footnote 37 – a psychological riddle that required solving in the long nineteenth century. Louyer Villermay already used the expressions susceptibilité morale, constitution morale, disposition morale, organisation morale and ultimately caractère to account for what might set women up for becoming hysterical from thwarted love, or a man for hypochondriac reactions. Many mid-century authors nominated moral upbringing.Footnote 38 Where by the early 1890s the general emphasis was on disposition, Breuer, with Freud, saw conflicts related to starkly sexed ideas of moral purity (sittlicher Reinheit, moralischer Reinheit) as causing ‘the first emergence of sexual feelings and ideas’ to require repression in girls.Footnote 39 This seemed to definitively shift psychiatric aetiology from the vulnerable female pubertal body to the fragility of the adolescent mind. Freud’s and Breuer’s nosographic circumscriptions of ‘virgins’ anxiety’ (virginale Angst, Angst der Adolescenten) and Pubertätshysterie isolated the adolescent girl’s anticipation of or encounter with ‘the sexual problem’: the ‘sexual ideas and feelings which crowd in on them [die auf sie eindringen]’, their ‘sudden sexual enlightenment’.Footnote 40 Subsequent life crises presented new ‘traumas’ and stresses; for women: honeymoons (Angst der Neuvermählten Footnote 41 ), contraception, menopause, widowhood. Freud’s early sexual theory of anxiety neurosis interestingly gave way to his seduction theory. In a 1896 footnoted corrigendum he stated that what had seemed to him ‘virgin’s anxiety’ was actually the awakening of a childhood memory apropos an initial, postpubescent encounter with ‘the sex problem’.Footnote 42
Where the affective habitus of Woman had translated to hysterical diathesis, something similar may be said of the onanist – the double victim of self-abuse and an original seduction to the habit.Footnote 43 Masturbation’s pathologisation expressed epochal moral and social anxieties, as Thomas Lacquer has laboriously argued,Footnote 44 but it was the masturbator’s own anxiety that was increasingly regarded nosogenic. One encounters a projection of ‘Troubles and Agonies of a wounded Conscience’ already in the early eighteenth-century Onania.Footnote 45 Leipzig psychiatrist Carl Wunderlich ventured by 1850 that ‘on the whole, the worst consequences of onanism occur only with the full awareness of immorality and the shame of that habit, even if the offense has long since ceased’.Footnote 46 Krafft-Ebing equally stressed the ‘shaming and frightening [self-]awareness of the onanist’: his ‘affects and pangs of consciousness (remorse, shame, fear of consequences)’.Footnote 47 This aligned well with Breuer and Freud’s psychic trauma: in December 1892 they comparably nominated ‘any experience which calls up distressing affect – such as that of fright, anxiety, shame or physical pain’ as causal element in hysteria.Footnote 48 Here, too, the question of trauma is actually a question of moral diathesis. Breuer, more clearly than Freud, saw masturbation as a problem only ‘in an adolescent with moral sensibilities’.Footnote 49
Primary aetiological roles for especially male self-confidence in neurasthenia and hypochondria had earlier been conveyed in the notion of impotentia psychica Footnote 50 (the ubiquity of which Freud himself would emphasise in 1912) and the roughly coeval concepts of syphilophobie (a term coined in or around 1836), sexual hypochondriasis (circa 1852) and hypochondrie syphilitique (circa 1860). By the mid-1880s, spermatophobia (fear of seminal loss) impressed as ‘an acute psycho-cerebral disease belonging to the order of depressive melancholia’.Footnote 51 The term was later extended to a case of a widow who, after a wet kiss by a rejected suitor, obsessed over possibly having been ‘contaminated by sperm’.Footnote 52 This was still hardly ‘sexual trauma’, and hysteria was ruled out. However, by the early 1890s, the once neurological calamities of self-abuse and sexual dysfunction had securely become clinical psychological ones, with increasing attention to melancholia masturbatoria,Footnote 53 the pathogenetic significance of masturbatory fantasy and concomitant ‘cognitive associations’ (Ideenassociationen: Binet/Schrenck-Notzing).Footnote 54 Not surprisingly, by 1891 the compunctious child masturbator and the rape attempt victim figured as equivalent vignettes identifying émotions morales as proximate causes of hysteric fits.Footnote 55
In much of eighteenth- and nineteenth-century sexual aetiology, sex had been less traumatic to women than infectious, contagious, addictive and transfixing for both sexes. Post-1850s clinical interest in homosexuality and perversion converged on congeniality and degeneration; but from the late 1880s psychological approaches gained ground.Footnote 56 This revitalised an additional major area of nineteenth-century pathogenic considerations of sexual experience. Sexual victims emerged with increasing frequency in the case descriptions of their offenders; at the same time, deviates and offenders were figured as themselves potential victims of ‘seduction’ and chance experience, specifically of ‘acquired pederasty’ (from 1884–6, by Benjamin Tarnowsky) and of fetishistic fixation (from 1887–8, by Alfred Binet).Footnote 57 By the mid-1890s Viennese discussions of the harm (Schädlichkeit) of sexual experiences, such as Breuer’s in 1895, were more likely than not to refer to ‘homosexual seduction’.Footnote 58 In 1887 Binet considered all perversion to result from ‘an accident acting on a predisposed subject’: ‘an external circumstance, an accidental event, doubtless forgotten’.Footnote 59 The gesture clearly spoke to the later intrigue of ‘sexual trauma’. Schrenck-Notzing traced one ‘neuropathically predisposed’ man’s homosexuality, after ‘repeated careful questioning’, back to the man’s having had his ears boxed, at age 4–5, for glancing at his father’s penis during urination.Footnote 60 This rendered his ‘undifferentiated sexual feeling … pathological and inverted’. Freud himself considered ‘the character of [infantile] sexual scenes’ and ‘accidental circumstances’ as capable of ‘[fixating] neurotic attention’ in anticipation of hysteria.Footnote 61 He also likened seduction to ‘a handing-on, an infection [Infection] in childhood’, with tuberculosis and smallpox as analogies.Footnote 62 These established pathogenic mechanisms troubled the fledging concept of Sexualtrauma as well as Freud’s self-analytic belabouring of the nursemaid scenario: in abused boys at least, libido was ‘prematurely awakened’ as well as fixated by precocious experience, turning the critical issue of childhood ‘sexual passivity’ into the more problematic one of targeted activity and pleasure.Footnote 63 Where in 6 December 1896 and 24 January 1897 letters to Fliess, Freud’s famously brought hysteria and ‘perversion’ (unspecified) together as ‘negatives’ tied equally to ‘premature sexual experiences’, then, this was only one attempt among many in the 1890s to bring together trauma theory and sexual theory. To name just two, Féré similarly wrestled with ‘moral shock’ as a factor in the genesis of sexual inversion and perversion; he considered an abnormal impressionability a critical element.Footnote 64 In 1895, Havelock Ellis reported three cases of sexual inversion where a history of ‘disappointment in normal love which, acting upon a predisposed organism, produced a profound nervous and emotional shock. In four [other cases] there was seduction by an older person, though in two of these there was already a well-marked predisposition’.Footnote 65 ‘Shock’, then, spoke widely to mid-1890s sexual theory.
Féré and Freud reinscribed a common concept of disrupted sexual quietude. Repercussions of untimely sex from the early modern period onward had been captured in internationally shared juridical terms, projected upon victims, of moral injury, corruption of the mind or moral corruption (Fr: corruption des mœurs, corruption morale) and demoralization.Footnote 66 During the nineteenth century the concomitant psychological stakes were variably conveyed in such abstractions as mental purity (Seelenreinheit), sexual innocence (geschlechtliche Unverdorbenheit, geschlechtliche Reinheit, geschlechtliche Unbefleckt heit) or moral integrity (moralische Integrität, sittliche Unversehrtheit, Unbescholtenheit).Footnote 67 Cited terms provided a sufficient and durable lexicon for compassion in the helping professions. A legal textbook of 1848 illustratively tied women’s experience of rape to ‘destruction of female honour, of the proud feeling of a respectable girl never to have served a man for extramarital satisfaction of sexual desire’, and children’s experience of Unzucht (abuse, assault) to the ‘moral depravity’ (moralische Verworfenheit) of their being ‘morally corrupted’ (sittlich verdorben).Footnote 68 One district physician wrote apropos a forensic examination in 1860: ‘The harm the child had suffered was not only physical but also moral. Although there was a prospect of eradicating the syphilis of the lamentable child, we had to question whether the psychic, demoralising influence on the later life of the child would not be far more serious, though currently unpredictable. At the tender age of eight, the girl had already been deprived of her innocence and so prematurely initiated to the secrets of sex life.’Footnote 69 Heavily connoted in ‘corruption’ was less the implied ‘premature excitement of the sex instinct’Footnote 70 than its projected social and physical corollaries. A school teacher taking advantage of multiple underage girls had ‘instructed them in immorality, prematurely excited their sensuality, morally corrupted them’;Footnote 71 a man sodomising young boys had ‘poisoned [their] mental and physical health’ by implanting in them the habit to masturbate, which would have led to multiple deaths.Footnote 72
Sittliche Corruption, with connotations of promiscuity and prostitution, long remained the primary qualification of ‘seduced’ children by medical men. By the 1900s, world-leading sexologists such as Moll, Iwan Bloch and Leopold Löwenfeld, as well as leading criminologists such as Erich Wulffen and Friedrich Leppmann, all identified the plight of the sexually abused child in general terms of moral corruption and psychosexual precocity, if also in updated terms of homosexualization (Invertierung) and perverse fixation. Interest in mental coping remained heavily framed by forensic interests in establishing evidence, with immediate reactions, where relevant, considered to speak to the legal question of consent.Footnote 73 Where in 1858, leading forensic expert and paediatrician Johann Ludwig Casper (1796–1864) extended what he called psychologische Diagnose from offenders to victims, he hardly described its scope.Footnote 74 The driving concern was to detect cases in which malicious caretakers set the child up for false allegations serving extortion purposes; a ‘truly innocent, pure child’ would behave differently, such children being ‘extremely reserved in their answers’ and found to use a different sexual vocabulary. This would inform the caretaker’s and child’s credibility, not the latter’s psychological coping.
French attention to underage sexual abuse notably did not follow Casper’s lead. Eighteenth-century forensic medicine had offered an etiological-anatomical distinction between physical and moral virginity (physicalische/physische vs. moralische Jungfrauschaft).Footnote 75 To Paul Bernard (1828–86) among other forensic experts, the latter concept assumed a psychodiagnostic rather than anatomical valence (demonstrating ‘chastity’), however a discounted one: ‘Examination of moral virginity [virginité morale, ie. of the child victim of sexual attacks] is not of great importance to the physician. Casper attaches some value to what he calls the psychological diagnosis. After what we have said about simulation in vicious children, we understand that this diagnosis, in many cases, is absolutely illusory.’Footnote 76 The child was too cunning to be taken seriously in psychological terms, and if at all, still largely in terms of witness credibility, not mental wellbeing. Paul Brouardel (1837–1906), under whom Freud studied in the mid-1880s, speaks comparably of ‘moral defloration’ (défloration morale), which he suggests must be taken as seriously as physical defloration.Footnote 77 It was a juxtaposition that had been made on several earlier medical occasions;Footnote 78 however, Brouardel hardly psychologised the offender, less still the victim. ’[He] often joked that the number of individuals who became hysterical or epileptic because they had seen a goat was considerable. This fact is true, but it is certain that the goat is only the drop of water that makes the vase overflow (and I do not know why). It is the same for indecent assaults.’Footnote 79 In his dying year he held on to this scepticism, leading him to presume symptoms encountered in offence victims to be pre-existent.Footnote 80 He also denied any specificity to physical or behavioural corollaries in long-term child victims.
4 Psychic Pertubation
In nineteenth-century law pertinent to German-speaking regions, moral offences were captured in evocative medico-juridical metaphors of violated boundaries and sensibilities: Schändung (‘violation’), Schamverletzung (Attentate auf das Schamgefühl, Angriffe auf die Scham/Schamhaftigkeit, Verletzung des Schamgefühls, Schamattentat), Sittenverletzung/Sittlichkeitsverletzung and Gefühlsverletzung (compare the more general notion of law violation, Gesetzesverletzung).Footnote 81 These legal terms often referred to public decency but recall ancient Roman law, which declared as injuria (insult, invasion of another’s rights) any attempt against the chastity of male youths still wearing the praetexta, or a respectable woman or young girls. Of sporadic eighteenth-century attestation and usually connected to rape, the synonymic terms Geschlechtsehre (sexual honour) and weibliche Ehre (female honour) received substantive definition as an object of legal protection (Rechtsgut) in nineteenth-century legal medicine. As Francisca Loetz has extensively sketched, these durable legal concepts of injury communicated legal and social entitlements coterminous with gendered citizenship: virtue, honour, shamefacedness, ‘name’.Footnote 82 Their nineteenth-century psychologisation was a cardinal but protracted and problematic process.Footnote 83 Punishable acts were denounced in terms of ‘ruin’ or ‘defilement’ that was ‘moral and physical’ only in the most formulaic sense.
Nineteenth-century English and American legal terms were carnal abuse (carnal knowledge) and carnal ravishment, terms old enough to require extensive legal exegesis,Footnote 84 but typically no reference to victim impact. To ravish a woman was ‘to violate a person’s chastity by force’, with chastity commonly considered (here apropos a discussion of Lucretia) ‘seated in the heart of mind and not in the body’.Footnote 85 A quote by English Judge Sir Michael Foster (1689–1763) was widely cited in nineteenth-century legal medicine to characterise this injury: ‘A Woman in Defence of her Chastity may lawfully kill a Person attempting to commit a Rape upon her. The Injury intended can never be repaired or forgotten. And Nature to render the Sex amiable hath implanted in the Female Heart a quick Sense of Honour, the Pride of Virtue, which kindleth and enflameth at every such Instance of brutal Lust.’Footnote 86 Shame and modesty were the defining characteristics of eighteenth- and nineteenth-century postpubescent womanhood: their compromise carried the rhetorical weight of social annihilation.Footnote 87 An early account of a sixteen-year-old girl’s hysterical reaction to paternal rape, by Esquirol, was thus appropriately featured in an article on suicide.Footnote 88 In 1835, Devergie, too, only briefly noted the worst of rape outcomes but was sure to address its psychological dimensions: ‘Death can be the consequence of rape. It is then due to a syncope that comes from the shame and horror that can be experienced by a woman while she is being raped. This is what has been observed frequently during wars, when several soldiers engaged in an unbridled debauchery have abused, one after the other, a woman until she succumbed under the influence of their horrible brutality.’Footnote 89 By 1857 Tardieu briefly connected rape more generally to psychic disturbance (perturbation morale): ‘various nervous disorders, such as syncope, delirium, convulsions, or acute and violent fever, a feeling of weariness and fatigue often accompanied by tearing chest pains. … Rape is sometimes the starting point of a hysterical affection, [his textbook added: chorea] and, more rarely, of epilepsy. … The shame, the fear of dishonour, have driven the victims of rape more than once to suicide.’Footnote 90 Young victims were thought (by Tardieu and others, even Freud) subject to precocious puberty, and physical wasting.Footnote 91 This short passage, otherwise focusing mostly on somatic symptoms, remained unrevised into the sixth, 1878, edition of Tardieu’s textbook. By this time, the immediate reaction of syncope was still often cited as the only psychological reaction of immediate medico-legal pertinence in the English literature: it ‘would no doubt favour the designs of the seducer’.Footnote 92
Pudeur blessée (injured sense of shame) would explain four of 596 female cases of mental alienation seen between 1838 and 1843 at the Saint-Yon mental asylum (acute fright explained twenty-seven).Footnote 93 It would explain sixty-nine out of 10 357 cases of madness (folie) counted in 1866.Footnote 94 In similar dubious reports, rape may have been commonly subsumed under ‘acute fright’, by far the most commonly cited of determining ‘psychic’ causes of mental illness, especially (after Tissot and Esquirol) ‘epilepsy’.Footnote 95 There was, in any case, a well-established basis for rape as one predisposing cause for ‘hystero-epileptic’ events before mid-century. Rape contributed eleven of 444 ‘epilepsy’ cases explained by causes morales (out of a 529 grand total) counted in 1854.Footnote 96 The link with hysteria proved increasingly precarious. Hysteric patients were held to be at increased risk for rape; hypnotic treatment presented one well-discussed risk for abuse. In cases of ‘hysterical insanity’ or ‘hysterical hallucinosis’ (hysterische Hallucinose), moreover, rape was named an established delusional or fictitious motif.Footnote 97 Briquet counted only two pertinent cases of rape among hysterics (of a 591 total); placed, however, in a miscellaneous group of rare determining causes.Footnote 98
Discussions of actual cases are not many. Defending an emotional hypothesis of hysteria, chair of the medical clinic at the Hôtel-Dieu de Paris, Auguste-François Chomel (1788–1858) connected one patient’s hysteria to rape, and another’s to being ‘railed by a mad dog’; to ‘a moral cause, a great fright which has violently shaken her nervous system’.Footnote 99 An unnamed author in 1837 noted: ‘The determining cause of catalepsy we observed in a young girl was an attempt at rape. The first bout came immediately, and the mere memory of this violence sufficed to bring it back.’Footnote 100 Paediatrician Eugène Bouchut recalled that in 1849, an eleven-year-old girl was brought in paralysed in tongue and limbs after an attempted rape by a peasant, far from Paris.Footnote 101 Money was raised to get her to Paris, where she soon recovered spontaneously, demonstrating the power of imagination: she ‘had the immense advantage of possessing unlimited confidence’ in the Parisian doctor. Swiss epileptologist Herpin described one case (out of sixty-eight) where ‘the onset of epileptic attacks closely followed’ a sexual attack.Footnote 102 Bénédict Morel just briefly mentioned two cases of ‘melancholy, with alternation of stupor and maniacal agitation’ he attributed to sexual assault.Footnote 103 An 1866 article briefly mentioned convulsions and ‘mental disorder’ followed by a suicide attempt after an attempted rape by a girl’s father.Footnote 104 In 1871 Eulenburg discussed one case of tonic seizure after sexual assault in a nineteen-year-old girl.Footnote 105 In a twelve-year-old girl presenting with seizure with hysterical fits, reported in 1875, symptoms were held to be ‘directly attributable to the rape committed upon her’ by a boy.Footnote 106 After a rape attempt, another twelve-year-old girl reported in 1890 ‘became extremely depressed, listless, pale and weak, lost appetite and sleep, and began to complain of giddiness, cardiac palpitation, and general malaise’ (the reason for consultation was a putatively consequent skin disease).Footnote 107
These scattered accounts remain descriptive, if anything held to be characteristic only to the wider etiological significance of terror. Some cases remained doubtful even where rape is explicitly acknowledged as a possible cause. In 1891, Halle Nervenarzt Alt illustratively noted, apropos a case of an hysterical seventeen-year-old girl, that ‘as experience learns, sexual factors [Sexualia] of the most varied kind, but in particular (successful or unsuccessful) sexual assaults [sexuelle Attaquen] play a very prominent role in sudden-onset, severe forms of hysteria’.Footnote 108 Digital exploration suggested that ‘there has been some sexual abuse [sexueller Missbrauch] here – whether with or without the patient’s consent, can at present not be decided’. The patient furthermore had a worm infection – maybe this presented an etiological moment.
Victoria Bates found that from 1879 onward witness and expert testimonies in sex offence contexts in England evidence the deployment of concepts such as nervous shock and nervous depression.Footnote 109 Cited terms seek a semantic kinship with the coeval trope of psychical shock; at the same time, they more faithfully echoed characterisations of ‘premature’ sexual excitation by well-read authors like William Acton. English forensic medicine offered very little substantive reflection. Early literature had associated rape with the dramatic outcome of acute dementia. One woman depicted in 1840 suffered from ‘acute dementia … it is said, by having been violated’.Footnote 110 Bucknill and Tuke mentioned a seventeen-year-old woman who, after a rape, never spoke a word again and became ‘completely demented’; an autopsy revealed ‘a somewhat softened state of one portion’ of the brain, ‘probably of recent date’.Footnote 111 This striking image of primary or acute dementia was cited by a number of mid-1890s authors, who seemingly had few other reference points.Footnote 112 More specific accounts by this time drew strictly from Tardieu.Footnote 113 In British literature of the late nineteenth century, rather, symptoms of adverse sexual experiences were often considered gynaecological in nature. ‘Mental shock’, often linked to sexuality, was generally thought to result in amenorrhea or menorrhagia.Footnote 114 Occasional etiological inferences about mental shock in relation to hysteria foregrounded ovarian function, and tended to concentrate on casualties of love rather than rape. These, then, would not lead to psychic pain but to aggravated menstrual discomfort. One textbook states of hysterical dysmenorrhea:
When … the cause can be traced to mental shock – and that kind of mental shock is the most distressing sexually that arises from the sudden disruption or perversion of sexual affection, from disappointment in love, or the death or absence of the lover – the symptoms become more centric, more concentrated in the sexual organs, and the dysmenorrhea is more intense. For in such cases the ovaries have to a certain extent responded to impressions which are associated with, or dependent upon, their natural function; the cherishing of these impressions has tended towards their growth and activity, and it stands to reason that any mental blow which the discriminating brain transmits to that part of the organism in direct nervous and sentient relation with those manifestations of the mental state which we call affection wounds that organism in proportion to the state of advancement of its development and to the suddenness and gravity of the blow itself.Footnote 115
Another case, of asthenic insanity, was connected exclusively to a woman being abandoned on her wedding day with concomitant financial ruin; here, too, ‘the patient’s whole system suffered; her menstruation ceased; she became sleepless, and rapidly lost flesh’, and so on.Footnote 116
While before 1895 virtually all reference to sexual assault seems to have remained isolated, a rare formal forensic acknowledgment of adverse sexual experience in the German literature is given in an 1874 article by Richard von Krafft-Ebing. It provides an interpretation of §224 of the German Penal Code (which had come into effect on 1 January 1872) pertaining to aggravated bodily injury, defined as consisting of ‘sickness, paralysis or mental illness [Geisteskrankheit]’.Footnote 117 The formulation led to a number of commentaries with regard to the scope of mental illness. Krafft-Ebing suggested that ‘terror [Schrecken], as we know, has a profound effect on the nervous system and can directly cause, apart from mental illness, the most serious nervous diseases (hysteria, epilepsy)’.Footnote 118 Three aetiological mechanisms for mental illness required distinction: (1) purely mechanical injuries (eg. trauma capitis); (2) rather more psychic insults (psychischen Insult), the latter causing a more diffuse psychic shock (psychischen Shock); and (3) rape: ‘mental illness following an attack on sexual honour [Angriff auf die Geschlechtsehre (Nothzucht)]’.
‘Because the literature offers very little’ on the third category, Krafft-Ebing provided three case studies. One deals with an eighteen-year-old girl servant ‘without hereditary disposition to nervous diseases, formerly healthy, not yet menstruated’, who ‘at the age of 14 became the victim of an immoral attack by her foster father’. Krafft-Ebing related that: ‘The undefinable disturbance in the central nervous system originally caused by the psychic shock developed into a state of hysteria (diffuse neuralgic pains, especially in the intercostal tracts, myodynia, globus sensations, with whose combined exacerbation the mood turned into a depressive one, settling into a considerable emotional irritability).’ Next are mentioned episodes reminiscent of migraine, but containing elements of reliving: ‘delirious attacks of two hours duration, each triggered by the phantasm of the foster-father wanting to repeat his shameful attack … The seizures turn out to be a hallucinatory delirium revolving around the phantasm of the intended rape and its being defended against.’ Case two deals with a twenty-five-year-old peasant girl who, in a village inn where she served, was attacked in bed at night, violated and left with a virulent leucorrhoea. ‘Deeply worried about the loss of her honour and the disease, she returned home, where she was ill-received and grievous (melancholia, with syphilitic insanity, anxiety and despair, taedium vitae). A failed suicide attempt led her to the asylum.’ This patient, too, developed ‘hysteric convulsive attacks and spells of hallucinatory delirium’.
The concluding case study is that of an unmarried maid, who at age nineteen experienced attempted rape by a teacher, presenting with ‘status nervosus with vague neuralgia, nausea, headache, feeling of tightness and anxiety in the epigastrium’. This exacerbated to ‘a state of intense precordial melancholy [Präcordialmelancholie] with tremendous anxiety, urge for destructive actions, hostile apperceptions, and delusion that she was going to be locked up in the penitentiary’.Footnote 119 Multiple hospitalisations followed (in 1862 and 1865). Epileptic-hysterical attacks that ensued included ‘hallucinatory reproduction of the rape [Nothzuchtsgeschichte]’: ‘Characteristic was always the image of the school teacher and the delirium revolving mainly around the attempted assault.’Footnote 120
Anticipating Pierre Janet’s work on dissociation and Charcot’s attitudes passionnelles, mentioned hallucinatory flashbacks seemed to suggest a distinctive pathological mechanism; Krafft-Ebing also observed them in a case of physical assault. Similar phenomena were reported in connection to sexual assault already by Briquet, and later by Gaube, Brouardel, arguably Oppenheim, and Cullerre – seemingly all independently.Footnote 121 But Krafft-Ebing’s suggestive etiological breakdown did not sensitise him, or anyone else, to extend the study of rape victims. In his general psychiatry textbook, first published in 1879–80, he subsumed one of his three cases (the first: Hysterismus nach Nothzucht) under ‘temporary mental disorder’ related to hysteria.Footnote 122 Krafft-Ebing here reiterated the gendered role of sexual shock but stressed a predisposition to ‘fixation’ after affective shock in general.Footnote 123 Until his death in 1902, Krafft-Ebing reported only incidentally and very briefly on girl victims of sexual assaults (always apropos occasional case studies of offenders), finding ‘corruption’ but little else. His work on female sexual dysfunction mostly discussed ‘unsympathetic’ marital relations, jealousy, forced abstinence and fear for pregnancy.Footnote 124 One assault victim (aged ten and a half) gave ‘the impression of a bold, not uncorrupted girl’.Footnote 125 Circa fourteen ‘half-grown schoolgirls’ were said to have been ‘morally corrupted and carnally used [sittlich verdorben und fleischlich gebraucht]’ by a teacher, Krafft-Ebing reports in an 1894 article.Footnote 126 As one cause for female sexual neurasthenia, in 1895 Krafft-Ebing mentions women being ‘tortured by remorse for past sexual abuse’: girlhood self-abuse.Footnote 127
With reference to Krafft-Ebing’s 1874 article, leading forensic psychologists, including Eduard Hoffmann and Joseph von Maschka, did pay brief attention to the psychology of adult rape victims in their textbooks.Footnote 128 However, both problematised causality, identifying a multitude of mediating or confounding factors that might complicate a sufficient causal link between experience and psychiatric outcome (including, in Maschka’s case, the contingency of the victim having been devoted to onanism, ‘as in such individuals nervous disorders sometimes occur spontaneously’). Hofmann tied ‘spasmodic epileptoid conditions … causally linked to rape attempts on them’ to children’s ‘tender constitution’ or stress-reflex responses to ‘peripheral stimuli’.Footnote 129 Moreover, caution was urgently advised regarding these conditions as possibly being pre-existent or exaggerated: ‘lies and exaggerations on the part of the relatives and also of the children themselves are not among the rarities’. Other authors likewise eschewed monocausal appreciations of sexual violence. Cited by Maschka, an illustrative Italian report discussed a case of an eighteen-year-old woman presenting with ‘melancholy with suicidality’ in apparent response to a sexual assault by a beloved, leading to repeated suicide attempts and a two-month hospitalisation, after which the patient was declared ‘cured’.Footnote 130 The author identified ‘poor mental development’ and apparent recent head trauma as ‘predisposing factors’ to the woman’s condition. Maschka himself details the coping of an eleven-year-old girl after a sexual offence; she was declared ‘entirely cured’ after six weeks.Footnote 131 But in another case of a ‘repeatedly abused’ fourteen-year-old girl, Maschka was unable to causally connect the experiences with ‘temporarily recurring convulsive, epileptoid seizures’.Footnote 132
5 Pathogenic Secret
Vienna neurologist and criminal anthropologist Moriz Benedikt, a notable critic of Krafft-Ebing and colleague and apparent friend of Freud, was an early advocate and, more importantly a patient defender of the idea of hysteria’s rooting in emotional turmoil. Benedikt’s (1835–1920) work merits brief attention as it worked toward a clinical sensibility for negative sexual experience contemporary to Breuer and Freud’s, earning him their acknowledgment, in 1893, for presenting ‘the nearest approach’ to their own. Already in writings between 1868 and 1874 Benedikt subscribed to the finding that: ‘Undoubtedly the most frequent cause of hysterical symptom-complexes are psychic influences such as insults, fearful excitement, anger, fright and the like. … maltreatment is especially the common cause of childhood hysteria, especially also hysteria in boys.’Footnote 133 He also suggested hysteria was intimately connected with anomalies of sexual life.Footnote 134 In early articles ‘abnormalities of the sexual life’ and ‘traumas with the psychological background of maltreatment’ (Traumen mit dem psychologischen Hintergrund der Misshandlung) remained separate factors. The former would affect women more readily than men given women’s impressionability and men’s capacity to project; the latter explained Hysteria virilis in boys. Nosogenic, ‘unusual active or passive sexual stimuli’ covered ‘love injuries’ (Liebeskränkung) and any over- or understimulation in sexualibus (impotent husbands, sexual anaesthesia).Footnote 135
Benedikt’s contemporaneous ‘psychophysics of morality and law’ presented a curious attempt to pinpoint the cerebral locus of morality, but he also placed moral development (sittliche Entwicklung) in social context. This suited his career-long concern for the close ties between honour (Ehr), conscience, sexual decorum and mental health issues such as suicide.Footnote 136 Benedikt returned to these themes in his later Seelenkunde, published on the eve of Freud’s seduction papers. Here Benedikt meditates on the psychology of moral injury (seelische Verletzung) in relation to social transgression (Sittenverletzung) outside forensic contexts, enabling him to address more generally than Krafft-Ebing and other forensic experts the intricate interplay in hysterics between mental suffering (Seelenleid), symptom and the idea of suffering.Footnote 137 What he called inner psychic experience (Seelen-Binnenleben or Binnen-Seelenleben) again referred urgently to sexuality (for inner experience is ‘probably the richest developed under the banner of sexual love’), especially female sexual experience (for ‘in comparison to the male sex, the inner life of the female is generally incomparably richer’).Footnote 138 Hysteria cases called for a medical psychologist (ärztliche Psycholog) attentive to ‘the mysteries of the positive and negative sexual life’.Footnote 139 Such attentiveness led Benedikt to suspect past sexual abuse in one adolescent girl presenting with attacks of respiratory-phonetic spasm, taunting him with the prediction, ‘You will not cure me!’ He was quickly able to elicit a curative disclosure, to her aunt, of the patient’s secret of having been repeatedly molested at age ten and to learn that mentioned symptoms were related to the girl’s occasionally running into her violator ‘who had since made a career’.Footnote 140
Benedikt’s clinical sensitivity may have had only one success to claim pertinent to the present discussion. It is somewhat qualified by his conviction that homosexuality was acquired and that homosexuals needed punishment – unless they had the luck of still being minors: ‘Even the accusation, and still more the punishment, definitively corrupts them [minors], while they can be saved morally and socially by an explanation of the abomination of their being misused [Mißbrauchtseins].’Footnote 141 He also considered Krafft-Ebing’s Psychopathia sexualis harmful to minors. Benedikt’s sexual victimology, then, contained a rare pointer beyond Breuer and Freud’s to the primary significance of sexual-experiential harms, but offered limited clinical empathy for the supposed casualties of ‘corruption’.
Egregious psychiatric outcomes of negative sexual experience were reported throughout the nineteenth century. Despite suggestive case studies such as Krafft-Ebing’s, psychological vantage points for sexual experience such as animating the work of Benedikt, Binet, Féré, Breuer and Freud, long remained unavailable. ‘Attacks’ (psychogenic nonepileptic seizures and hysteria) were the most commonly cited consequences of sexual assault, rendering monocausal ties at the mercy of governing ideas about predisposition in such afflictions. General gestures toward psychic trauma, by the early 1890s, were daring in this respect; Freud’s eventual seduction theory was more daring still. Benedikt’s assumptions about female psychic vulnerability, Féré’s notion of psychic-moral shock and Breuer and Freud’s early formulations of sexual trauma flattered Enlightenment ideas about childhood innocence and early modern concepts of female modesty. Considered more pertinent to boys, tried concepts of moral corruption were by now increasingly giving way to two new guises: fetishistic fixation and homosexualization. These experiential theories ultimately fractured Freud’s developmental sexual trauma along established gender lines, an arguable early step toward Sexualtheorie: from Trauma to Komplex.