the Carmel

Word from the psychiatrist

A strange disease

Thérèse's illness at the age of 10, from Easter to Pentecost 1883
by Dr Marie-Dominique FOUQUERAY psychiatrist.

Psychiatrist since 1984, and licensed in theology since 1995, Dr. Fouqueray, in addition to his liberal activity as a psychiatrist, studies the psychology of people declared saints to know how they went through the trials of life with their faults and weaknesses to make it a path of conversion and holiness. Thérèse Martin, doctor in the sciences of love is one of them, especially since she is a beacon to enlighten the little souls of the 3rd millennium.

Where does Thérèse talk about her strange illness?

In manuscript A, from folio 25v° to folio 31:

“Now, I must speak of the painful ordeal which broke the heart of little Thérèse, when Jesus took away her dear mother (reminder of the first trauma that was the death of her mother at 4 and a half years old, on August 28, 1877) until 31 r° of manuscript A. It is important to specify that the strange illness arrived when Thérèse was 10 years old, beginning on March 25, 1883, at Easter, and lasting until Pentecost on May 13, 1883, according to the manuscript A, folio 27v° to 31v°.

You can read its full text in the following section: "What They Said About It", with the stories of her two most involved sisters: Marie as a nurse, and Pauline as a family support.

What value should be given to Thérèse's writings?

Thérèse has an excellent memory. She wrote her manuscript A in 1895, at the request of her sister “Sr Agnès de Jésus (her second mother who was in fact her sister Pauline Martin). She was then 22 years old, 12 years after her strange illness. It is a rereading of what she experienced that she delivers to her reader. She is able to describe her feelings and her symptoms as if it were yesterday, which makes her an excellent patient in psychoanalysis, she wrote in her spare time at Carmel, which is restricted and is like a punctuated psychoanalysis session for her by the sound of the bell recalling the hour of prayer. We know that it is she who writes, in her room, it is possible to see the photos of her writing desk, her pen and inkwell, the composition of the ink... She writes out of obedience to Mother Agnès, she was horrified from “pretence”, she desires to sing the mercies of the Lord through her weaknesses. She is aware of her weakness and smallness, since she speaks of it many times in other passages.

How serious is this disease?

Dr. Notta, consulted in 1883 at the request of Uncle Guérin, declared that Thérèse was suffering from a very serious illness (Manuscript A, folio 27 verso). While specifying that it was not hysteria, Dr. Notta was unable to make a precise diagnosis of Thérèse's illness, given the medical knowledge of the time.
He suggests treating it with wet wraps, a treatment that is still practiced today for psychotic patients who are referred to as " packing » wet wraps, hydrotherapy to try to contain abnormal movements or hard-to-bear anxieties.
Le packing is a treatment technique consisting of temporarily wrapping a patient in cold, damp cloths. This technique is used either for children suffering from infantile autism or for psychotic adults, in particular during the recovery period. It is also sometimes used for disorders of the elderly where, as for the other indications, it is a question of helping them to regain a certain awareness of their body image.

Alphonse Henri Notta


He was born on February 26, 1824 in Fourqueux (Seine-et-Oise), and died on July 23, 1914 in Lisieux (Calvados). Doctor of medicine, having practiced all his life in Lisieux (extern in medicine in 1846 — intern in 1847).
His doctoral thesis is on "Research on the healing of the arteries", it was completed in 1850. He was a member of the National Academy of Medicine (surgical pathology section) from December 10, 1878; and member of the Anatomical Society of Paris from 1847. A page on his "Memory on the obliteration of the umbilical arteries and on umbilical arteritis" is available online on the website of the Lisieux Electronic Library:

What is the context of the outbreak of the strange disease? and the first symptoms?

1) Thérèse learned by surprise in the summer of 1882 that her sister Pauline was going to enter a convent. But for Thérèse it was a betrayal, because her sister Pauline had promised to wait for her. And Thérèse understood that she was going to lose her second mother. Here are her strong expressions that describe well what she is going through:

“Oh! How could I tell the anguish of my heart? »
"In an instant, I understood what life was...I saw that it was only a suffering and a continual separation"
"I shed very bitter tears...I was weak, so weak...a test that seemed to be far beyond my strength!"
"Having heard it by surprise, it was as if a sword had plunged into my heart" (see Saint Luke 2:35).
“I can still see the place where I received Pauline's last kiss” Thérèse has a very developed visual memory. This hypermnesia may be linked to the traumatic shocks she experienced before. First of the family separation when Mrs. Martin could no longer feed her daughter and Thérèse to live had to be placed as a nurse at Sémallé, at Rose Taillé's, in March 1873 for 13 months. Then, from the second trauma caused by the death of her mother when she was 4 and a half years old on August 28, 1877

 2) October 2, 1882: two events will once again provoke strong reactions in Thérèse. On this day of October 2, 1882, his sister Pauline returned to Carmel. That morning, Thérèse cannot accompany her sister because it is her return to school as a half-boarder. For Thérèse, leaving the family unit was already difficult for her, as well as returning to class at the Abbey.

The first conscious trauma that Thérèse describes is that of the death of her mother in Alençon on August 28, 1877. She describes it as a state of amazement: her father makes her kiss her mother's cold forehead without her expressing the slightest emotion; she is 4 and a half years old, she does not remember having cried, which means that she did not mourn the death of her mother. The consequences of this death are the change of character: from happy, he becomes sad; Therese becomes excessively hypersensitive, a trifle will provoke tears revealing a traumatic affective immaturity. The loss of his second mother Pauline reactivates all of this. The visits that follow at Carmel are a terrible suffering for Thérèse, who can only speak to Pauline for a few minutes, it is a great frustration. Pauline is not aware of her sister's fragility, and causes a new trauma for Thérèse who had complete confidence in her. This will be the bed of his strange illness, with the emergence of symptoms. Towards the end of 1882, a continual headache began but this did not prevent Thérèse from continuing her studies and suddenly, no one paid any attention to it. The first symptoms of his strange illness begin to manifest. 

Thérèse in a state of post-traumatic stress

Following all the stress that Thérèse had experienced since the summer of 1882, her health deteriorated strangely in December: she was continually plagued by headaches and pains in her side. She eats little, sleeps badly; buttons appear. Her character also changes: she sometimes gets angry with Marie, and even bickers with Céline, who is so close to her. In the parlor of the Carmel, Pauline worries about her younger sister, to whom she lavishes advice and affectionate reprimands.
During the Easter holidays, as we have seen, the crisis is triggered. However, there are also times of normality, which clearly shows that Thérèse is not affected by psychosis or schizophrenia, which would then completely invade her field of consciousness.

Several times a day, she suffers from nervous tremors, hallucinations and fits of fright. Then she is seized with a great state of weakness and, although she retains all her lucidity, she cannot be left alone. However, the patient repeats that she wants to attend Pauline's habit, scheduled for April 6. On the morning of the fateful day, after a particularly strong crisis, Thérèse gets up as if by a miracle and, apparently cured, goes with her family to the Carmel. She spends the whole day thus, full of gaiety and enthusiasm. But the next day, it is a brutal relapse: the patient is delirious and seems deprived of her reason. The doctor, very worried, still cannot find the origin of his illness. Louis Martin wonders if his "poor little girl" will not die or sink into madness.
The whole family prayed for Thérèse, a novena of masses was said at the Notre-Dame des Victoires church in Paris, and a statue of the Virgin was placed in her room. But the patient only temporarily regains her reason when she receives a letter from her Carmelite sister, which she reads and rereads many times.
On May 13, 1883, the day of Pentecost, Léonie, Marie and Céline tried to calm Thérèse, who did not recognize them. Powerless to relieve her, they kneel at the foot of the bed and turn towards the statue of the Virgin. Thérèse would later recount: "Finding no help on earth, poor little Thérèse had also turned to her mother in Heaven, she begged her with all her heart to finally have pity on her...". Thérèse was then overwhelmed by the beauty of the Virgin and above all by the smile she gave her: “Ah! I thought, the Blessed Virgin smiled at me, how happy I am...”. At this moment, the patient relaxes in front of her amazed sisters. The next day, all trace of the disease disappears, except for two small alerts in the following month. Thérèse remains fragile, but she will not suffer any new manifestation of these disorders in the future.
The doctor having advised the family to avoid any strong emotion for the little girl, she is now pampered to excess by those around her.
At the end of May 1883, she was able to resume visits to Pauline, in the visiting room of the Carmel. Questioned by her sister Marie, Thérèse who had nevertheless promised herself to keep the secret of the Virgin's smile, ended up telling her everything. The Carmelites cry out for a miracle and press her with questions. Her joy then changes into suffering: she imagines that she has betrayed the Virgin. Especially since an insidious doubt seeps into her: didn't she fake her illness? She would write: “I imagined that I had lied...I could not look at myself without a feeling of profound horror. Ah! What I have suffered, I can only say in heaven! Doubt and guilt will plague her for five years.

Prior to the 19th century, individuals who exhibited similar symptoms were thought to be possessed by spirits. A very strong interest in spiritualism, and hypnosis followed during the 19th and early 20th centuries. This is why Thérèse will quite naturally interpret her illness as the work of the devil, who "received a power" over her.  

Diagnosis of this strange disease

Thérèse suffers from post-traumatic stress disorder (PTSD). This state is defined as a set of symptoms that develop when a person has been exposed to a traumatic event that generates significant and sudden distress. With Thérèse, it's the betrayal of Pauline who leaves for the convent without waiting for her, it's the wound of abandonment by her second mother. Two existential shocks for the child, who had not mourned his first mother, who died in 1877. Faced with this type of event, it is normal to feel a shock: this is the so-called "stress" reaction. acute", which usually lasts less than a month. In some people, this period of stress persists for an abnormally long period, from several weeks to several months, accompanied by disorders which, on fragile psychological ground, can cause a peritraumatic dissociative crisis. This is what happens for Thérèse at 10 years old.

This strange disease is now diagnosed as a seizure dissociative, a dissociative disorder of the person. It is an identity disorder, like a phenomenon of psychic disintegration, having an important impact in the connections of the brain. The traumatized person constantly relives the event through memories, dreams or flashbacks that take them by surprise. Sometimes, the physical sensations felt at the time of the trauma reappear unexpectedly. These symptoms are accompanied by a tendency to run away from anything that might remind you of the trauma. This attitude of avoidance can lead to partial or total amnesia of the events.
The affected person also experiences a certain feeling of emotional numbness and detachment. She has the impression of having lost contact with her environment, the feeling of constantly evolving in the fog, abnormally cold and distant.
Other symptoms may occur: sleep disturbances, irritability, distress, difficulty concentrating or hypervigilance (exaggerated fear of the outside world). The generalized and severe anxiety disorder characteristic of this post-traumatic stress disorder sometimes manifests itself in anxiety attacks or panic attacks. If the person has or believes to have a share of responsibility in the traumatic event (during a road accident, for example), the anxiety is often accompanied by a loss of self-esteem.

After several months, these symptoms have a strong negative impact on daily life and well-being. Complications can arise, such as guilt and psychic fragility. At Thérèse, she will still remain partly immature and it is the grace of Christmas 1886 that will help her to go through the stages of maturation.

The treatment

1) Listening first: giving the patient the opportunity to speak to help him integrate what was very difficult for him. Post-traumatic stress disorder can be effectively treated with psychological intervention. 
2) Cognitive-behavioral therapy on trauma-related thought processes when memories come back. Post-traumatic stress disorder often resolves over time. 
3) EMDR therapy, which helps reprocess traumatic memories from the past. It is a neuro-emotional integration therapy by alternating bilateral stimulation (eye movements or other), discovered in 1987 by an American psychologist Francine Shapiro. It allows the restarting of a natural processing of blocked painful information (for example after a traumatic shock), the mobilization of psychic resources and the restoration of a deficient self-esteem.
4) If necessary, an antidepressant may be needed.


Going through the anguish of abandonment again with the unforeseen departure of Pauline, Thérèse goes s'exercer to go through anguish, passing from the path of the anguish of abandonment, to the path of abandonment and trust. First in the hands of her sisters, then in the hands of the Virgin Mary with the novena made to Notre-Dame des Victoires. It was through the death of her mother Zélie that the trauma entered Thérèse's life and it was through the grace coming from the smile of the statue of Mary, mother of God, that Thérèse found peace. This smile of Mary is for Thérèse an unspeakable but fundamental spiritual experience: Mary will become for Thérèse her true mother, this gift that Jesus makes to Saint John at the foot of the cross (Jn 19, 27). But this grace will take time to be fully accepted in Thérèse's heart. And she is going to prepare the reception of another more striking grace which will be the grace of Christmas, which Thérèse calls her conversion, and which will be the beginning of her giant race. Thérèse will still have to let go of other "egotic" attitudes (linked to her Ego) to leave all the room for Jesus. When, under the pressure of her sister Marie, she will recount this grace of a smile, it will then be for her the beginning of a new ordeal, that of scruples. Because as long as this grace is not fully integrated into Thérèse's deep heart, it turns into scruples: Thérèse believes that she dreamed or imagined this grace...

This is a very clear example of the flow of God's grace in a person. Other ordeals will be necessary for Thérèse to be able to say under the impulse of the Holy Spirit: "In the heart of the Church, my mother, I will be love", the culmination of her total gift. Or even when she wrote at the end of her life: "Oh I would like to sing Marie why I love you", which is far beyond her experience of Marie's smile.