21 - The Ganser syndrome

Summary

S.J.M. Ganser was born in Dresden on 24 January 1853 (Allen, 1993; Allen & Postel, 1993, 1994) and trained in Würzburg, Strasbourg, Heidelberg and Munich (Anonymous, 1901). His contribution to psychiatry has not been yet well studied (Allen, 1992). Ganser died in 1931, and only remains known for the state of ‘twilight hysteria’ that he observed in persons awaiting trial (Ganser, 1898).

The ‘Ganser syndrome’

The term ‘Ganser syndrome’ is found in use very early in the century (e.g. Soukhanoff, 1904; Cramer, 1908; Nitsche & Wilmanns, 1912). In its entirety, this clinical cluster includes the following features: (i) disorganized sense of space and time; (ii) production of ‘I don't know’ answers even to simple questions (which, in Ganser's opinion, implied the ‘suspension of information’ usually at the person's disposal); (iii) clouding of awareness; (iv) ability to understand questions matched by a psychogenic inability to give correct answers; (v) answers remain in the semantic sphere of the question (Vorbeireden) (Marneros, 1979) (e.g. how many ears do you have?) Three, etc. Ganser himself exemplified: ‘As if a railway employee gave you a ticket at random’ rather than the ticket you asked for; the point being that he did not give you a bucket of water or a cup of tea (Ganser was thus not writing coq-à-l'âne); (vi) the patient experiences hallucinations, and may re-enact or relive in a hallucinatory manner certain traumatic experiences; […]