Railway Neurosis and the Birth of Psychotherapy (August/September 2003 | Volume: 54, Issue: 4)

Railway Neurosis and the Birth of Psychotherapy

AH article image

Authors: Michelle Stacey

Historic Era: Era 4: Expansion and Reform (1801-1861)

Historic Theme:

Subject:

August/September 2003 | Volume 54, Issue 4

When four airplanes used as missiles in acts of terrorism on September 11, 2001, killing almost 3000 people, many of the millions who watched the horror on television made a secret vow: I am not going to step onto an airplane again. They knew this decision was irrational, and ultimately untenable, but it seemed the one small thing that a terrorized populace could do. We could opt out of the technological sophistication that had made such wholesale slaughter of innocents possible. We could return to seemingly simpler, more controllable ways to be transported: automobiles, buses, and trains. In the days after September 11, those modes began to seem comforting—even, in the case of trains, gently nostalgic. Air travel dropped almost 40 percent in the United States right after the attacks.

Therapists and phobia specialists talk about how our collective “illusion of safety” was temporarily torn away on that day, but a portion of the population has always been afraid to fly. Being lifted 35,000 feet into the air and carried through the sky at 500 miles per hour somehow defies the basic rules of our Earth-bound human physical reality. To see an already intimidating technology twisted into an obscene and unimagined vehicle of death struck a deep, almost inchoate, chord of fear.

Air travel has since rebounded almost to pre-September 11 levels, and the everyday miracle of flying has been reincorporated into most Americans’ mental and emotional geography. But that step could never have been possible without a much larger one that took place a century before the jet age, when a new kind of vehicle changed forever the way Americans could travel. That swift and powerful vehicle was the very one that now appears so reassuringly low-tech and safe: the railway train.

In the mid-nineteenth century, before which humans were never transported any faster than a horse could gallop, trains provoked in many people not only excitement, but a raw fear at least as strong as today’s fear of flying, and for similar reasons. The trepidation became so marked and so common that it acquired its own name—railway neurosis—and, ultimately, its place in history as perhaps the first recognized psychosomatic illness. Many historians credit railway neurosis, and the battles that the diagnosis caused among doctors, with a key role in the development of the field of psychotherapy. The arguments that raged about railway neurosis pointed the way toward the treatment of shell shock in World War I and even toward our understanding of the lingering effects of the trauma of September 11.

Railway neurosis began as a condition called railway spine, which was not considered psychological at all. This condition was first described at length in 1866 by a British surgeon, John Eric Erichsen, who defined it as a physical reaction to being in a train accident, not too unusual an event in the early days of railroading. Erichsen outlined an exhaustive list of symptoms - all, he speculated, caused by