Tuesday, July 25, 2006

‘Hitting Highs at Rock Bottom’: LSD Treatment for Alcoholism, 1950–1970

This is an abstract of a current article that discusses an interesting recent episode in the history of psychiatry. Althought it was taken seriously as a treatment a little more than 50 years ago, LSD treatment is almost as hard to imagine as the mythical Melampus' use of hellebore with milk to treat the daughters of Proetus. If your interested you can find the latter at "Case Histories from the History of Psychiatry."

Sunday, July 23, 2006

Odors, now and then

Reading in the New York Times (7/21/06) that "French psychiatrists…have found that lavender-laden air can reduce agitation among certain psychiatric patients", I was reminded of ancient beliefs about hysteria.
Regarding the various symptoms of hysteria as the result of the migration of the womb, Aretaeus of Cappadocia, an ardent second century A.D. follower of Hippocrates, explains that the womb "delights, also in fragrant smells, and advances towards them; and it has an aversion to fetid smells, and flees from them; and, on the whole the womb is like an animal within an animal." He goes on to say that the "uterus in woman has membranes extended on both sides of the flanks, and also is subject to the affections of an animal in smelling; for it follows after fragrant things as if for pleasure, and flees from fetid and disagreeable things as if for dislike. If, therefore, anything annoy it from above, it protrudes even beyond the genital organs. But if any of these things be applied to the os, it retreats backwards and upwards. Sometimes it will go to this side or to that,--to the spleen and liver, while the membranes yield to the distension and contraction like the sails of a ship."
These theraputic suggestions were criticized by Soranus if Ephesus, a leading authority on gynecology in the 2nd century A.D., in his discussion of hysteria:

"the majority of the ancients and almost all followers of the other sects have made use if ill-smelling odors (such as burnt hair, extinguished lamp wicks, charred deer's horn, burnt wool, burnt flock, skins, and rags, castoreum with which they anoint the nose and ears, pitch, cedar resin, bitumen, squashed bed bugs, and all substances which are supposed to have an oppressive smell) in the opinion that the uterus flees from evil smells. wherefore they have also fumigated with fragrant substances from below, and have approved of suppositories of spinenard [and] storax, so tht the uterus fleeing from the first-mentioned odors, but pursuing the last-mentioned, might move from the upper to the lower parts."

No mention of lavender.

Quotes from Ilza Vieth, Hysteria: The History of a Disease, (University of Chicago Press, 1965) 23-30.

Psychiatry in the twenty-first century: Garden State

In the film Garden State [2004], 26 year-old Andrew Largeman comes home, after nine years, from Los Angeles to New Jersey, when his mother dies. We learn that his psychiatrist father thinks that Andrew has never been able to forgive himself for causing his mother to become paraplegic when he was nine years old. In addition to sending Andrew to a boarding school at age 16, father has been prescribing and Andrew has been taking a cocktail of 3 SSRI's, lithium and depakote. When the story begins Andrew is shown as numb to all feeling, but he forgets his medications in Los Angeles, and through the four days that the film depicts we see Andrew becoming progressively more able to respond emotionally. Of course there is a plot, which gives Andrew plenty to respond to, but the film is also a, not too subtle, critique of the numbing of society by psychotropic drugs. Reference to Brave New World completes the picture. In addition to the iatrogenic effects of psychoactive drugs, the film also points to the destructive consequences of the psychiatrist-father's insistence that Andrew suffers from being "unable to forgive" himself for what we are told was just an accident. Ian Holm's portrayal of the father's solemn, but misguided, benevolence also parodies psychiatry as a profession of would-be sages.

Saturday, July 15, 2006

Psychotherapy in the twenty-first century

I recently saw a woman for a medication consultation who was quite shy about expressing her feelings directly to others. She was having difficulties with a boyfriend and had gone into therapy to discuss her feelings about this. In relating her story to me, she clearly was having a hard time talking about what she was experiencing. After a few minutes, she paused and said, "This would be easier if I could read you my texts." With that, she took out her cell phone and proceeded to read me a series of text messages that she and her boyfriend had exchanged. I was quite struck by the nuanced account of the evolution of their relationship that could be gleaned from these very short and often eliptical messages. I asked her if she had read these texts to her therapist. "Of course," she replied, with some surprise in her voice, "I read them to her at each session. It helps me understand how things are going." I could believe that, though it was not quite the psychotherapy that I was taught way back in the twentieth century.

G. W. Albee, 84, Psychologist Who Tied Poverty and Illness, Dies

I had never heard of Albee before reading this obiturary. Though he wrote in the 1960s, it sounds as if he should be read today.

Monday, July 10, 2006

Response to Comments

I've gotten two recent requests.
One person is looking for more material on famous people with psychiatric disorders. Some cases of famous people can be found on my web site "Case Histories from the History of Psychiatry." I would also suggest the recent book by Joshua Wolf Shenk, Lincoln's Melancholy: How Depression Challenged a President and Fueled his Greatness."I liked it because it tries to show how emotional distress can lead to acheivemnets, as well as suffering.
A second person asked for historical images of the mentally ill. Again there are some on my web site "Case Histories …." I would also suggest two books edited by the historian Sander Gilman. 1. The Face of madness: Hugh W. Diamond and the Origin of Psychiatric Photography; 2. Seeing the Insane. I could also suggest "Madness in America: Cultural and Medical Perceptions of Mental Illness before 1914," by Lynn Gamwell and Nancy Tomes.