Falling Into the Fire: A Psychiatrist's Encounters with the Mind in Crisis
Page 26
short-stay, 13–14, 99
threats of violence by, 78–79, 116, 135–40
vulnerability of, 2–3
see also specific individuals
Patty (self-mutilation patient), 34–35
pediatricians, 7, 142
pedophilia, 136
penises:
self-amputation of, 35
shrinking and disappearing of, 12, 198–200, 202
pep squad, mass psychogenesis in, 196–97, 203
pharmaceutical companies, 30
phenothiazine, 130
Phillips, Katharine, 72, 73–75, 77–78, 81
Phyllis (seizure patient), 169–75, 177, 178, 180, 182, 184, 188, 190, 207
Pierre, Jean, 155–56
Plath, Sylvia, 110, 113
polyps, 31
Ponte Vecchio, 123
possession, demonic, 200–201
postpartum psychosis, 30, 112, 157
postpartum stress, 150–51, 155
post-traumatic stress disorder (PTSD), 169–70
poverty, 31
preaching, 121
pregnancy, stress during, 150
Price, Lawrence, 30–31
prodromal phase, 109
projection, 45–47
projective identification, 45–47, 50
prostitution, 55
Prozac, 79
pseudoseizures (psychogenic nonepileptic seizures), 171–80, 182, 185, 188, 195
history of, 190–93
Psychiatric Times, 140
psychiatry:
author’s hard questions about, 1–3, 16, 17, 90–91, 93, 112–14, 119, 126–33, 147–48, 207–16
difficulty of determining a diagnosis in, 108–9, 126, 128, 132, 137, 146–47, 157–58, 163–64, 166, 170–75, 182–84
doctor’s nonjudgmental stance in, 181–82
domain of, 11–12
emergency procedures in, 166–69
historic evolution of, 13–17
intersection of medicine and, 163–205
lack of certainty in, 168
as medical discipline, 11
mission of, 106
myths and misperceptions about, 30–31, 105, 107
perceived as pseudoscience, 30
responsibilities of, 3–4, 208, 211
risks to practitioners of, 98–99
shortcomings of, 106
surgery vs., 26
Psychiatry: An Industry of Death, 30
psychogenic movement disorders, 176
psychogenic nonepileptic seizures (pseudoseizures), 15, 171–80, 182, 185, 188
history of, 190–93
psychogynecology, 189
psychology, 11
psychopharmacology, 30
“Psychophysiology of Self-Mutilation” (Haines), 50
psychosis:
delirium vs., 165–66
euphoria and, 106–8
in harming of children, 140–41, 144–47
obsession vs., 146–47, 158
in self-mutilation, 33–35, 59
see also schizophrenia
psychotherapy, 16
for BDD, 73, 80
in BIID, 88
for depression, 30
for pseudoseizures, 176
psychotic filicide, 142–43, 147
quadriplegics, 12
Quiet Room, 169–70, 174
racism, 143
Raving Madness, 15
rectal insertions, 35
reflexes, 8
Reid, Russell, 88
rejection, 50
religious and spiritual delusions, 56, 59, 97–121, 126, 128, 130–33
faith vs., 119
in harming of children, 140, 143–44
mass psychogenesis in, 200–201
in self-mutilation, 33–35
see also Colin
“Repetitive Self-Injurious Behavior: A Neuropsychiatric Perspective and Review of Pharmacologic Treatments” (Villalba and Harrington), 47–48
repetitive self-mutilation syndrome, 37
reproductive system, in hysteria, 184–85, 189
research, ethics of, 48–50
Resnick, Phillip, 141–44, 147, 159–60
respiratory rate, 7
restraints, in hospitalization, 16
rhinoplasty, 72
Rhode Island:
author’s home in, 212–13
hurricane in, 93–96
involuntary hospitalization in, 104
Riggi, Theresa, 142
risk, author’s avoidance of, 164–65
Roethke, Theodore, 208
Sackellares, J. Chris, 172
Sacks, Oliver, 106
saints, 12, 130–31
Saks, Elyn, 169
Salpêtrière Hospital, 190–92, 196, 201
Santa Croce, Church of, 123
Santa Maria Nuova Hospital, 122
Satan, 140, 143
scabs, reopening of, 36
schizophrenia, 69, 91, 103, 111, 116–17, 168, 169
and BIID, 108–9, 115–16
catatonia in, 11
Schumann, Robert, 111, 113
Scientific American, 150, 153
Scientology, 30
Scott, Charles, 8–9, 180
scrotums, 200
Sears, Roebuck and Company catalog, 188
seclusion, 169–70
security guards, 20–22, 28–29, 39, 40–41, 98
sedation, sedatives, 5, 7, 29, 30, 173–74, 177, 178
Sedda, Anna, 92
seizures, 7, 12, 143, 170–76, 178, 180, 182, 188, 207
see also Phyllis
self-amputation, 33, 49, 56–60, 85–86, 90
self-fulfilling prophecy, projective identification as, 45–47
self-help, morbid forms of, 36
self-image, self-harm and, 67–96
self-injury, 19–65, 165, 200, 208
anger and resentment at, 37
disconnection in, 32–33, 50–54, 55
ethical issues in, 56–60
feedback loop in, 36–37, 59
through ingestion, see intentional ingestion
involuntary hospitalization and, 104
normal aversion to, 32–33
physiology of, 51
root causes of, 47–50
through self-mutilation, 33–37
sense of calm and relief through, 33, 36, 47, 49–51, 75
sequence of events in, 50–51
three types of, 33
as unintentional consequence of BDD, 72–75
self-mutilation, 33–37
self-soothing, 53
Selma (BDD patient), 79
sensory loss, 9
separation, self-injury prompted by, 50
September 11, 2001, terrorist attacks of, 52, 145
serotonin, 78
serotonin reuptake inhibitors (SRIs), 76, 79–80
sex:
body identity and, 85
irregular actions and desires in, 83, 139, 201
as motivation for self-injury, 34, 35, 200
perceived relationship of hysteria to, 184–89
Sexton, Anne, 110, 112
sexual abuse, 48, 53–54
Shakespeare, William, 1, 19
shame, in doctor-patient relations, 183–84
Shelley, Percy Bysshe, 110
“shell-shocked,” men, 184–85
Shorter, Edward, 84, 181, 188
short-stay patients, 13–15
sigmoidoscopy, 35
Simon, Robert I., 116
sinfulness, as motiva
tion for self-mutilation, 34
Singapore, 198
skin, in BDD, 67–70
Slater mental hospital, 44
Smith, Robert, 85, 88
Smith, Susan, 143
Smith, Thornton, 197
Smithsonian, 185
snapshots, residents’ game with, 99–101, 106
somatoform disorders, 180–84, 193–96
throughout history, 184–88
misinterpretation of, 196
somatoparaphrenia, 91–93
sparrow, 115
speaking in tongues, 200–201
spinal cord, 11
spouse-revenge filicide, 142, 144
Standal, Stanley, 181
starlings, group behavior of, 203–5
status epilecticus, 170–71, 173–74, 177, 179
Stendhal syndrome, 123
stereotypic self-mutilation, 33, 35–36
sternal rub, 5–6, 8
“Stopping by Woods on a Snowy Evening” (Frost), 19–20, 64
Strasbourg, 198
stress:
cortisol and, 150–51
ingestion as response to, 23–24, 31, 33, 46–47
of isolation, 48–49
in mothers who harm children, 152–54, 155–57
self-mutilation as response to, 36–37, 51
social, 31, 154
in somatoform disorders, 194–95, 202–3
stroke, 7, 11–12
Strong, Marilee, 53
stupor, 11
subcision, 81
submersion, as therapy, 16
suicide:
attempted, 21, 115–16
in BIID, 99, 106
as consequence of BDD, 73, 77, 79
drug overdose in, 7
and filicide, 138, 139, 144, 155–56
genius and, 112
hospital precautions for, 27
passive, 73
self-injury vs., 33
tendencies toward, 1, 29, 86, 88, 107, 122, 164, 209
threats of, 39, 166
superficial/moderate self-mutilation, 33, 36
superglue, 72
Supreme Court, U.S., 105
surgery:
ability to cure by, 26
for amputation, 56–60
author’s dream about, 41–42
cosmetic, 68, 72, 73–74, 75–77
dental, 71
as effective in BIID, 83–84, 86–93
historical dangers of, 188–89
for ingested objects, 19, 23–27
self-, 72
Swallow: Foreign Bodies, Their Ingestions, Inspiration, and the Curious Doctor Who Extracted Them (Cappello), 42
symptom exaggeration, 8–9
symptoms:
tests for neurological validity of, 8–10
see also specific symptoms
Szasz, Thomas, 30
Taking of the Christ (Caravaggio), 132
Technology of Orgasm, The (Maines), 186
teeth, in BDD, 71, 74, 79, 86
testicles, self-amputation of, 35
Thailand, 198
“Thorazine shuffle,” 105
thyroid, 21
tics, 193–94, 202
Today, 202
Tourette’s disorder, 36
tourists, psychotic episodes of, 119–24
tranquilizers, 171
Transcultural Psychiatric Review, 200
transformation, 126–27
transgendered people, 35
trauma:
dissociation and, 52–53
neurological effects of, 47–48
retelling of story as reexperiencing of, 145–46
Troilus and Cressida (Shakespeare), 19
tumors, 32
Uffizi gallery, 122
unemployment, 31, 209–11
unresponsiveness, 5–11, 17
obstructionist, 11
unwanted child filicide, 142–43, 144
Ursuline nuns, 200–201
USA Today, 118
uterus, in hysteria, 184, 187, 189
Vancouver ferry, 149
van der Kolk, Bessel, 47–48
van Foreest, Pieter, 186
van Gogh, Vincent, 110, 113
veterinary medicine, 7
vibrators, 186–88
vigilance, maternal, 151, 153
Vijay (medical student), 102–3
Villalba, Rendueles, 48
vital signs, 5, 7
voices, hearing of, 15, 56, 83, 109, 115, 116, 138–39, 144–46, 166
vulval massage, see genital massage
Waller, John, 198
Wallian, Samuel Spencer, 187
Weatherston, Mary, 212
Weil, Simone, xi, 211
Welly (author’s friend), 81, 86–87, 96
West Virginia, 105
Whole, 88
winter camper (self-amputation patient), 56–60, 83
witchcraft, 201
Wolf, Mabel, 42–43
women, historical treatment of hysteria in, 184–89, 190–93
Woolf, Virginia, 110–12
World War I, 184–85
Wrigley, Charles Harold, 1, 13, 16, 70
wrists, cutting of, 51–52
X-rays, 32
Yates, Andrea, 140–41, 143–45, 155, 157, 158
Yates, Rusty, 157
youth, onset of mental illness in, 76, 108
(ABOUT THE AUTHOR)
Christine Montross is an assistant professor of psychiatry and human behavior and the codirector of the Medical Humanities and Bioethics Scholarly Concentration at the Warren Alpert Medical School of Brown University. She is also a practicing inpatient psychiatrist. Dr. Montross’s previous book, Body of Work, was named an Editors’ Choice by the New York Times and one of the Washington Post’s best nonfiction books of 2007. She and her partner, the playwright Deborah Salem Smith, live in Rhode Island with their two young children.