In his early clinical work, particularly in collaboration with Josef Breuer, Freud examined hysterical seizures — episodes that mimicked epilepsy but lacked a neurological basis. These were typically understood as expressions of repressed emotional trauma manifesting through the body.

In their joint work, Studies on Hysteria (1895), Freud and Breuer documented cases of patients (most notably Anna O.) who displayed dramatic, conversion-type symptoms: convulsions, paralysis, hallucinations, and seizures that had no organic cause. Freud believed these symptoms were physical manifestations of unconscious conflict, particularly related to repressed affect or traumatic experiences.

At that time, the term “hysteria” covered a wide range of presentations, many of which would now fall under what we describe as conversion disorder, dissociative disorders, or histrionic personality features. What we might today consider a “histrionic seizure” — a dramatic, attention-seeking episode resembling a seizure but not rooted in epilepsy — would likely have been categorized by Freud as a conversion symptom within hysteria.

Freud moved beyond the somatic explanations that had dominated 19th-century psychiatry and emphasized the role of unconscious psychological processes. He proposed that these seizure-like episodes were symbolic expressions of repressed emotions, especially of sexual or aggressive nature, often linked to early childhood experiences.

Though the language has evolved, and diagnostic frameworks have shifted significantly, the clinical phenomena Freud described — including seizure-like events driven by unconscious emotional conflict — remain relevant. Today, such episodes may be diagnosed as psychogenic non-epileptic seizures (PNES) or classified within functional neurological symptom disorder under DSM-5.