Falling Into the Fire: A Psychiatrist's Encounters with the Mind in Crisis (29 page)

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 motivation 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

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.