Concepts of nymphomania in the German academic psychiatry: Changes over the last two centuries

Abstract

This chronology aims to provide an overview of the views on nymphomania in the history of German academic psychiatry over the past 200 years. The aim of this study was to answer the following questions: What are the continuities over that period with regard to the etiology, diagnosis, classification or therapeutic recommendations? What changes can be observed? Was the increase in sexual desire in women seen as a disease or rather as a symptom? What significance did psychiatry attribute to female sexuality at a certain point in time? What reasons can be identified for the perceptions made and conclusions drawn at a certain time? A cursory review of the most influential German-language psychiatric textbooks of the respective period was conducted in chronological continuity. Relevant passages were identified, analyzed in detail and compared with each other, taking the historical context into account. At the turn of the 19th and 20th century, a clear break in the understanding of nymphomania as a disease could be observed. In the 19th century, it was seen as a severe mental illness, which was assumed to have been caused at least in part by a peripheral disease of the female reproductive organs and the nervous system associated with them, which could lead to irreversible terminal mental states. In the 20th and 21st centuries, nymphomania was perceived as either a sexual neurosis or a functional sexual disorder, limited to the symptom complex of hypersexuality. The reasons for this were, on the one hand, the overall change in diagnosis resulting from a comprehensive reclassification of mental disorders, which assigned nymphomaniac symptoms of the 19th century to both manic and schizophrenic disorders, and, on the other hand, changes in the perception of female sexuality in the social discourse in general. The fact that nymphomania as a diagnosis was eliminated with the 11th edition of the International Classification of Diseases is a clear expression of this change. The concept of nymphomania has undergone considerable changes over time. At the beginning of the 20th century, the understanding of the disease changed significantly, so that it is even possible to distinguish between an early and a late phase. The diagnosis has meanwhile become obsolete.