Tuesday, October 31, 2017

The Devilish Side of Psychiatry




The devil always experienced malicious pleasure in imposing himself in neuropsychiatric nosology


Olry and Haines (2017) published a mischievous article in the Journal of the History of the Neurosciences:
Having an inquiring mind by nature, the Devil always managed to interfere in all spheres of human activity, including the sciences. ... Biologists use an enzyme called “luciferase” — Lucifer has been described as the “light-bearing” fallen angel, hence the bioluminescence — to spot certain proteins by chromogenous reactions (Lodish et al., 2005, p. 92). ...

But how did the Devil get a foot — of course cloven (!) — into the door of the neurosciences?

Demonic possession plays an important role, of course, even in modern day psychiatric nosology (see the debate over Possession Trance Disorder in DSM-5). Does it make any sense to use DSM-5 (or DSM-IV) criteria to diagnose spirit possession across cultures? Transcultural psychiatry takes a much more inclusive and sensitive approach to such phenomena, which are often precipitated by trauma.

Olry and Haines (2017) avoid this literature entirely and suggest that:
The concept of demonic possession has been mainly of theological (Omand, 1970; Balducci, 1975; Rodewyk, 1988; Amorth, 1999, 2002; Bamonte, 2006; Fortea, 2006, 2008) and/or historical concern (Villeneuve, 1975; Pigin, 1998; Kelly, 2010; Kiely & McKenna, 2007).  ...

Although conservative theologians might not question the reality of diabolical possession (see Haag, 1969; Cortès & Gatti, 1975, for the few exceptions), many psychiatrists and psychologists admit being interested in the concept though, of course, not declaring themselves in favor of a supernatural etiology...

But being diabolical sorts themselves, the authors namedrop and show off their autographed copy of The Exorcist.



Figure 1. Title page of William Peter Blatty’s The Exorcist, with signed dedication by the actress Linda Blair. Author’s (R.O.) copy.



They continue:
However, literature and the movie industry — let’s remember William Peter Blatty’s The Exorcist (Blatty, 1971) (see Fig. 1) and the sociological impact of William Friedkin’s screen adaptation two years later (Bozzuto, 1975) — not only generated impassioned movie critics ... but also brought back scientific discussions involving neurosciences and, more specifically, psychology, neurology, and psychiatry (Montgomery, 1976).



Häxan (1922)entire film available at archive.org


Deadly exorcisms have been reported recently in the medical literature, including several cases of Fatal Hypernatraemia from Excessive Salt Ingestion During Exorcism. One 20-year-old woman received a prescription for Prozac to treat her postpartum depression, but her family also advised her to undergo an exorcism. She reportedly drank six glasses of a mixture of 1 kg table salt in a liter of water.

The Church itself involved physicians many centuries ago in the differential diagnosis between possession and mental disease, as exemplified by the 1583 Rheims National Synod:

[Before he undertakes to exorcize, the priest has to inquire diligently about the life of the possessed [. . .], of his health [. . .], because melancholics, lunatics often need much more cures of the physician than the ministry of exorcists.] (Tonquédec, 1948, p. 330)

Physicians, and in actual fact, clinical neuroscientists, then had to name a phenomenon — nosology oblige — about which most did not believe.


The Devil's Influence Over Neuropsychiatry – “some lexicological compromises”
...neuropsychiatrists sometimes allow themselves the use of theological concepts (e.g., possession, diabolical, demonological), provided that an additional term — medical or not — grants them a little more scientific credibility. This addition may be “neurosis” (demonological neurosis: Hélot, 1898; Freud, 1923), “psychosis” (diabolical possession psychosis: Lhermitte, 1944), “delirium” (diabolical possession delirium: Gayral, 1944; Delay, 1945), “syndrome” (possession syndrome: Yap, 1960), “phenomenon” (phenomenon of possession: Bron, 1975), “state” (possession state: Wittkower, 1970), or “experience” (possession experience: Pattison, 1969, p. 323).

Or sometimes the patient may feel like they are literally in hell.



Self-Portrait in Hell, by Edvard Munch (1903)



Reference

Olry R, Haines DE. (2017). The devil always experienced malicious pleasure in imposing himself in neuropsychiatric nosology. J Hist Neurosci. 26(3):329-335.


Further Reading

Possession Trance Disorder in DSM-5

Spirit Possession as a Trauma-Related Disorder in Uganda

"The spirit came for me when I went to fetch firewood" - Personal Narrative of Spirit Possession in Uganda

Possession Trance Disorder Caused by Door-to-Door Sales

Fatal Hypernatraemia from Excessive Salt Ingestion During Exorcism

Diagnostic Criteria for Demonic Possession



The Wailing (aka 곡성, , Gokseong)


...and to make your Halloween nightmares complete...



Although it's certainly not for everybody, The Wailing is an amazing film.

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1 Comments:

At December 21, 2017 2:25 PM, Anonymous Phillip Huggan said...

My personal favourite application is imaging whether someone is using ethics or morals when making a decision. Eventually this can port to gvmt and robotics and AI employees.
When you think about responsibility and ethics a deep little brain area called the precuneus lights up. Also, the pre-frontal cortex is activity or noticeably not active along with the cuneus being active. The latter two should be easy to image. Existing RF-coils can be shifted up or moved up to image the cuneus. Small magnetometers or cutting edge CNT magnet sensors can be placed on hair covering the cuneus. EEGs might be able to image enough pre-frontal cortex activity. No MRI needed. Brain imaging for all.

 

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