Falling Into the Fire: A Psychiatrist's Encounters with the Mind in Crisis

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Falling Into the Fire: A Psychiatrist's Encounters with the Mind in Crisis Page 25

by Montross, Christine

Elliott, Carl, 83, 90

  emergency room:

  author’s experience with, 19–23, 97–99, 163–69, 190, 207

  patient evaluation for, 3–6, 20–23, 99, 101–2, 125, 137–38, 163–65

  treatment protocol for, 172–73

  endoscopies, 24–25, 31, 58–59

  enucleation, 33–34

  epileptic seizures, 143, 170–71, 173–74, 177–79

  euphoria:

  malignant potential of, 106–9, 131–32

  spiritual state of, 12, 101–7, 109

  see also Colin

  Euripides, 135

  evaluation, author’s procedure for, 5, 7–8, 20–23

  executions, 52

  exorcism, 201

  exposure therapy, 158–59

  eyes, self-removal of, 33–34

  face, in BDD, 71, 72

  fainting, mass, 196–97

  Favazza, Armando, 33–37

  fear:

  author’s experiences of, 93–96, 131, 149–52, 182, 215

  of doing harm, 135–40, 159

  heightened senses in, 6

  plans vs., 158

  in schizophrenia, 116

  female genital self-mutilation, 34

  fetters, in hospitalization, 16

  filicide, 140–44, 208

  classification in, 141–43

  motivation for, 160–61

  in nature, 153–54

  risk matrix for, 156–57

  stress and, 150–54, 155

  finger foods, 20–21, 28

  fingers, in BDD, 73

  Florence syndrome, 121–23

  “foreign body,” 32, 52

  Foscolo, Ugo, 123

  Fourth Amendment rights, 124–25

  Fra Angelico, 122

  Frankel, David, 53

  Freiburg, University of, 189

  Freud, Sigmund, 45

  Friedrichs, Dr., 25

  From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era (Shorter), 84, 181, 188

  Frost, Robert, 19–20, 64

  frostbite, 86, 88

  Furth, Gregg, 84, 85

  Gabbard, Glen, 52

  gag reflex, 10, 16

  Galen, 185–86

  gangrene, 85

  gastroenterology, 19–20, 25

  gender dysphoria (gender identity disorder; transsexualism), 85

  gender reassignment, 87

  genetics, in mental illness, 78

  genital massage, 185–88

  genius, madness and, 110–13

  Georgia, 105

  Germany, 201

  Gloria (movement disorder patient), 193–96

  Gnarls Barkley, 97

  God, in religious delusions, 34–35, 117, 131

  Goodell, William, 186

  Grandier, Urbain, 200–201

  Great Britain, 78–79, 154–55

  hysterical men in, 185

  grief, dissociation in, 52–53

  Guardian, 118

  gynecology, 188–89

  Haines, Janet, 50–51

  hair, in BDD, 75

  hair pulling, 36

  Halim, Nadia, 121–22

  hallucinations, 33, 35, 56, 59, 146–47, 166

  hallucinogens, 103, 124

  hand, self-amputation of, 56–60

  Handel, George Frideric, 110, 111

  Harlow, Margaret and Harry, 48–49

  Harrington, Colin, 48

  Harvey, William, 184

  head banging, 36, 49, 170, 173

  health insurance companies:

  clinical decisions influenced by, 14

  economics of, 30, 62, 74, 89, 99, 175

  shortcomings of, 56, 62–64

  Hegar, Alfred, 189

  helplessness, 202–3, 210–11

  Hemingway, Ernest, 110

  Henry (nurse), 5–10, 196

  Highmore, Nathaniel, 187

  Hinduism, 118

  Hippocrates, 177, 185

  homelessness, 127–28

  homicide, 21

  of father, 15

  homosexuality, as motivation for self-amputation, 35

  hope, in BDD, 76–81

  Hôpital Sainte-Anne, 121

  hospitalization:

  admission to, 14, 37, 164–75

  involuntary, 12, 104–6, 163

  role of, 27

  Hudson River, 155–56

  hugging, Amma’s use of, 118

  humor, as coping mechanism, 42–43, 86–87, 100–101, 106

  hurricane, as metaphor for life trauma, 93–96

  hygiene, 4, 121, 124

  hyperstates, 106

  hypnotism, 192

  hysterectomies, 189

  hysteria, 184–89, 190–92

  mass, 196–203

  Hysterical Men (Micale), 185

  “hysterical paroxysm,” 185

  hystero-epilepsy, 191

  iatrogenic harm, 177

  “imagined ugliness,” 69

  Imlin’sche family, 198

  “In a Dark Time” (Roethke), 208

  India, 118–19, 198, 199

  infanticide, 141–43

  laws pertaining to, 154–55

  Infanticide Act (British; 1922), 155

  infection, 21

  inferiority, 78

  infidelity, projection in, 45–46

  intentional ingestion, 19–33, 42–43, 75, 207

  items swallowed in, 23–24, 25, 27–29, 31–32, 42–43, 208

  self-injury by, 12, 21–29

  see also Lauren

  Internet, 117

  interpersonal conflict, 50

  intubation, 177, 178

  “Iron Rations: Fakirs Swallow Swords, but Amateurs Take Cake Lunching on Hardware,” 42

  isolation:

  body image in, 69, 71

  desire for, 11, 16

  early, 48–49

  in filicide, 155

  social, 194–95

  Israel, 119–21

  Jamison, Kay Redfield, 112

  Jane 5 ward, 44

  Japanese tourists, 121

  Jehovah’s Witnesses, 90

  Jerusalem syndrome, 119–21

  Jesus Christ:

  Colin and, 97–98, 101

  delusions involving, 34, 56, 59, 120

  Jim and Wendy (author’s neighbors), 95

  Joan of Arc, 130

  Johnson, Eric Michael, 150, 153–54

  José (mental health worker), 190

  Joseph (catatonic patient), 3–11, 12, 16–17, 196, 207, 208

  Journal of Abnormal Psychology, 50

  Journal of Applied Philosophy, 88

  Journal of Clinical Psychiatry, 34

  Journal of Hand Surgery, 86

  Journal of Neurological Sciences, 92

  Journal of Neurology, 178

  Julie (BDD patient), 74–75, 86

  Justice Department, U.S., 141

  Kalogjera-Sackellares, Dalma, 176, 182–83

  Kay (grandmother’s friend), 114

  Kleeman, Jenny, 118

  Klein, Melanie, 45

  kleptomania, 37

  koro, 198–99, 202

  labor, 74

  LaFrance, W. Curt, Jr., 176–83, 193–96, 203, 208

  Lauren (intentional ingestion patient), 19–33, 207

  causes for disorder of, 50–51, 54–55, 56

  as chronically returning patient, 19, 29, 31, 43–44, 54, 60–62

  compared with amputation patient, 58–59

  failure of health care system for, 62–64


  family background of, 55

  hostility of, 21–23, 38–44, 46–47, 60

  projective identification as response to, 46–47, 50

  superficial/moderate self-mutilation in, 36–37, 59

  treatment strategy for, 31–33, 37–38, 51, 54–55, 56, 59–64

  Lee, Nathaniel, xi

  Levy, Neil, 87–89

  Lidofsky, Diana, 53

  lightbulbs, 19, 21–23

  Literary Digest, 42–43

  Little Green Men, Meowing Nuns, and Head-Hunting Panics (Bartholomew), 198

  London Eye, 149

  loss, death and, 209–11, 215

  Loudun, France, 200

  Lowell, Robert, 107, 110

  “lunatics,” 13

  Macbeth (Shakespeare), 1

  McGeoch, Paul D., 92–93

  McKee, Geoffrey R., 156–57

  Mad Pride, 110

  “Mad Tourists” (Halim), 121–22

  Maestripieri, Dario, 152–53

  Magherini, Graziella, 122–23

  “magical genital loss,” 199–200

  magnetoencephalography, 92

  Maines, Rachel, 186–88

  major self-mutilation, 33–35, 59

  malingering, 8–9, 180–81

  managed care, see health insurance companies

  mania, 127–28, 130

  depression and, 106–7

  manslaughter, vs. murder, 155

  marijuana, 21, 103

  Martha (tourist), 122

  Mary, Virgin, 34

  mass psychogenic illness:

  causes of, 202–3

  examples of, 196–202

  “Maternal Filicide Risk Matrix,” 156–57

  Matthew, Book of, 33, 67, 207

  Mayo Clinic, 72

  Medea (Euripides), 135, 142

  media, images of perfection in, 78

  Medical and Behavioral Treatment Plan, 26–28

  medication:

  effective, 30, 125–26

  ineffectiveness of, 29–30, 88, 145

  for mental illness, 16, 23, 29, 103–4, 119, 130–32

  misuse of, 127–28

  patient volition and, 12, 104, 105, 108, 163

  reliable use as important in, 31, 67, 79, 107, 116

  in seizure threshold, 171

  side effects of, 31

  see also specific drugs

  medicine:

  author’s evolving perception of, 1–2

  “cover your ass” (CYA) approach in, 165

  ethical issues in, 14, 25, 56–60, 85, 87–93, 104–6, 119, 125–27, 131–32

  financial issues in, 14, 16, 29

  hierarchies of decision making in, 164–75

  intersection of psychiatry and, 163–205

  judgment calls in, 128–30

  omission vs. commission in, 58–59

  potential treatment hazards in, 177

  shortcomings of, 17, 46–47, 77

  see also doctors; specific disciplines

  meditation, 17

  medulla, 10

  Melancholy, 15

  memories, personal, 13

  memory loss, 8

  men, and hysteria, 184–85, 189

  mental illness:

  dangers of undertreatment of, 107–8

  drug use in, 7

  ethical issues in, 56–60, 131–32

  historical treatment and mistreatment of, 13–17, 188–89, 190–93, 197–98, 200–201

  importance of correct diagnosis in, 12, 146–47, 157–58, 166, 176–77, 182

  interdisciplinary conference on, 109–13

  myth of romantic madness in, 15, 110–13, 132

  onset of, 115–16

  perceptual acuity in, 39–41, 136

  physical illness vs., 93, 129–30

  social circumstances vs., 29–30

  subjects as “spectacles” in, 15, 190–93, 201–2

  see also specific disorders

  mental retardation, 35

  Messiah (Handel), 111

  Mexico, 85

  Micale, Mark, 185

  Michigan, author’s fondness for, 65, 114, 147, 212, 213

  midwives, 186–87

  migraines, 11

  mind:

  as domain of psychiatry, 11–12, 17

  intersection of body and, 12, 163–205, 207

  mysteries of, 12

  minimal engagement, 4

  mirrors, obsession with, 68–70, 80

  misdiagnosis:

  dangers of, 12

  of depression, 30

  Missouri, University of, 33

  mockingbirds, 114–15

  Molière, 163

  Monica (manic patient), 127–28

  monkeys:

  bonding research on, 48–49, 55

  cortisol and stress in, 152–54

  Monro, Thomas, 16

  Montross, Christine:

  contemplation of hard questions by, 1–3, 16, 17, 90–91, 93, 112–14, 117, 119, 126–33, 147–53, 203, 207–16

  doubts and unease of, 1–3, 16, 17, 38–42, 44–47, 61–65, 77, 90–91, 108–9, 110, 116, 131, 160–61, 165, 168, 170–75, 180, 182, 212, 215

  evolving perceptions of, 1–2, 12–13, 207–16

  grandmother of, 114–15

  hurricane experience of, 93–96

  mission of, 2–3, 39–40, 106

  motherhood of, 6, 12–13, 61, 65, 82, 93–95, 114, 130, 133, 147–53, 164, 203–5, 213–16

  parents of, 148, 211

  partner of, see Deborah

  presentation on theme of madness by, 109–13

  psychiatry as career choice of, 2–3, 19, 167–68, 208, 212

  residency of, 3, 19, 39, 67, 72, 99, 163, 207

  as risk-averse, 164–65

  mood disorders, 30

  mood stabilizers, 29

  Morselli, Enrico, 69–70

  mortification, 200

  Mother Nature (Blaffer Hrdy), 153–54

  mothers:

  fears of, 149–53

  harming of children by, 135–61

  murders by, 141–44

  movement disorders, 176, 193–96, 202

  Mrs. Dalloway (Woolf), 111

  Munch, Edvard, 110

  Munthe, Axel, 192

  murder:

  manslaughter vs., 155

  of one’s own children, see filicide; infanticide

  mutilators, 51

  mystics, 12

  nail biting, 36

  Nancy (paranoid schizophrenic patient), 124–26

  Natchez, Miss., 197

  natural selection, 150, 153

  nausea, induced, 16

  neglect:

  child, 53–54

  in predisposition for self-injury, 47–48

  neonaticide, 141–43

  nerves, 11

  “nervous breakdowns,” 185

  Nervure, 121

  neurological examination, 5–7

  symptom validity tests in, 8–10

  neurology:

  BIID origins in, 91–92

  intersection of psychiatry and, 11–12, 172, 175–84

  neuropsychiatry, 176–84, 193

  Neuropsychology Review, 92

  New York, State University of, Buffalo, 117

  New York State, 202

  New York Times, 30, 118, 122, 196

  New York Times Magazine, 202

  New Zealand, 155

  Nigeria, 199–200

  nipples, in BDD, 73

  nonhuman primate research, 48–49

  nonmutilators, 51

&n
bsp; nonsuicidal self-injury, 35

  Northwestern University, 189

  noses, in BDD, 72, 74–75, 86

  nuns, 200–202

  nurses:

  briefing role of, 3, 169

  functions of, 20, 169–70, 174

  resentment felt by, 37–38, 46, 174, 182, 190

  object relations theory, 45

  Observationum et Curationum Medicinalium ac Chirurgicarum, Opera Omnia (van Foreest), 186

  obsession:

  in BDD, 67–81

  in BIID, 90

  command hallucinations vs., 146–47

  of harming child, 135–40, 152, 158

  obsessive-compulsive disorder, 36, 147, 158–60

  see also Anna

  ocean, as metaphor for life, 212–14

  O’Connor v. Donaldson, 105

  Ojibwa tribe, 201–2

  “ominous extravagance,” 106

  One Flew Over the Cuckoo’s Nest, 105, 107

  opiates, 7, 165, 180

  natural occurrence of, 50–51

  orgasm, as treatment for hysteria, 185–88

  Osiris, 15

  ovarian compressor belt, 192

  ovaries, 189, 192

  Oxford English Dictionary, The, 69, 83

  pain:

  assessing of, 9

  in BDD, 73–75

  as deterrent to self-injury, 33

  distancing from, 179

  as evaluative tool, 5–6, 8, 10

  lack of sense of, 35, 50–51

  as penance, 34, 200

  physical vs. psychic, 21–23, 47, 75, 86, 202, 208

  physiological response to, 6

  in psychogenic disorders, 181

  paralysis, 9

  paranoia, 15, 109, 115, 122, 123, 124–26, 143, 163

  paraphilias, 83

  parent-infant bonding:

  in attachment theory, 53

  research on, 48–50

  parenting:

  author’s experience of, 6, 12–13, 61, 65, 82, 93–95, 114, 130, 133, 147–53, 164, 203–5, 213–16

  psychiatry compared with, 13

  research on, 48–49

  parietal lobe, 92–93

  Paris, 190

  Paris syndrome, 121

  paternalism, 104

  patients:

  abiding with, 12, 136

  antagonistic stance of, 21–23, 38–43

  autonomy issues and, 12, 89–90, 104–6, 119, 125–27, 163

  briefing routine for, 3–4

  as chronically returning, 4, 14, 23–24, 99, 157, 164

  classification of, 14

  doctors duped by, 6, 136, 170–75, 180–84

  “gravely disabled,” 105

  as imposters, 182–84

  nonjudgmental relationship to, 181–82

  palliative measures vs. cures for, 26

  premature discharging of, 14, 23

  resentment engendered by, 37–38, 42–45

  self-perception of, 102, 103

  self-reporting by, 50

  sense of loss in, 209–11

 

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