Category Archives: bowels

Trump anxiety disorder

In the trenches: Jennifer Contarino Panning, Psy.D.

Safe place to discuss troubled feelings

Leafing through The Dangerous Case of Donald Trump (2017), Dalrymple comes across a chapter titled ‘Trump anxiety disorder: the Trump effect on the mental health of half the nation and special populations’, by Jennifer Contarino Panning, Psy.D. Panning explains that her experience derives from psychotherapy ‘clients’ in Evanston, Illinois,

a suburban, liberal, higher-socioeconomic status, and educated suburb . . . a college town, home to Northwestern University, with much of its sixty-five thousand residents comprising professionals who work at Northwestern . . . Most notably, the clients who came in the day after the election were still in disbelief. As their therapist, I concentrated on validating, normalizing and maintaining a safe place for them to discuss their troubled feelings. We also discussed basic self-care, such as getting enough sleep, eating healthy meals, connecting with friends and family, and limiting consumption of election news stories.

Importance of bowel regulation

The liberal élite exposed: the book inadvertently helps to explain the rise of Trumpism

Dalrymple notes that if his grandmother were still alive,

she would have stressed the importance of keeping the bowels regular too, preferably by a weekly dose of castor oil.

In the trenches

Panning says that her work

helped me not to feel as helpless; being ‘in the trenches’ with clients was a way to feel productive.

Dalrymple comments:

In the trenches! And these people dare to accuse Mr Trump of not being able to distinguish paranoid fantasy from reality!

In another article in the book,

a therapist draws a comparison between a woman abused by a jealous and violent partner and the population of the United States and Mr Trump. She means her analogy to be taken seriously and almost literally, not merely metaphorically. She seems not to realise how demeaning and insulting this is both to the population (particularly those actually abused by their partners) and the country’s traditions and history.

Rise of Trumpism

The book, says Dalrymple,

inadvertently helps to explain the rise of Trumpism. With a liberal élite like this, is it any wonder that a man should come forward who thinks that an offence given it is a blow struck for liberty and good sense? This book gives the liberal élite away.

Laxative therapy for agitated paranoiacs

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Lomax’s 1921 exposé

For most of their existence, writes Dalrymple, mental hospitals were

custodial rather than therapeutic institutions.

Their methods could be somewhat crude. In The Experiences of An Asylum Doctor, With Suggestions for Asylum and Lunacy Law Reform (1921), Montagu Lomax, a medical officer at Prestwich Asylum,

described how he and his colleagues treated suicidal melancholics and agitated paranoiacs. They sat the melancholics against a wall, placing a bench in front of them to prevent them from moving, while an attendant watched them to ensure that they did not do away with themselves.

Screen Shot 2016-05-12 at 07.49.48Croton oil, a very powerful laxative,

subdued the agitation of the paranoiacs, who became so preoccupied with the movement of their bowels that they had no time or energy left to act upon the content of their delusions.

A leading theory, Dalrymple notes, was that of focal sepsis.

One of the asylums of my city had the best-equipped operating theatre of its time, where an enthusiastic psychiatrist partially eviscerated his patients and removed all their teeth, on the theory that madness was caused by a chronic but undetected and subclinical infection in the organs that he removed.

Screen Shot 2016-05-12 at 08.31.18Later, a visiting neurosurgeon

used the theatre to perform lobotomies on patients who were scarcely aware of what was being done to them.

Doctors also tried

more ‘advanced’ treatments, such as insulin coma therapy, in which they gave schizophrenic patients insulin to lower their blood sugars to the point at which they became unconscious, sometimes with fatal effect.

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Companion volume to the Lomax work

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Prestwich Asylum

Prestwich Asylum

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A leading proponent of focal sepsis theory was Henry Cotton of the New Jersey State Hospital for the Insane, Trenton

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Patients became so busy with their bowels, they had no time to act on their delusions

The case for masterly inactivity

Rectal biopsy forceps

Rectal biopsy forceps. ‘My doctor,’ says Dalrymple, ‘whom I have never met, sends me (or rather his computer sends me) repeated calls for screening. I don’t want to know whether or not I have a 10 per cent chance of a heart attack within the next 10 years.’ Dalrymple always respectfully declines screening offers from fellow physicians. For example, when receiving a colonoscopy invitation, ‘I always tell myself I am too busy just now, I will have it another time.’

Many screening procedures, writes Dalrymple,

are doubtful at best; some do more harm than good, by arousing anxiety or by promoting unnecessary surgery, as well as through more immediate side-effects. Increasingly, the patient is not so much ill as the bearer of risk factors for disease, whose statistical effect the doctor attempts to nullify.

Annual health checks may be

a waste of time—unless wasting time by occupying it is the whole object of the activity, in which case wasting time is not wasting time but using it gainfully. Gainfully, that is, to the person who wastes his time (the doctor) rather than has his time wasted for him (the patient). His time is well and truly wasted.

There is, says Dalrymple,

the assumption that doing something must be better than doing nothing. Doctors of the past, because there was so little they could in fact do, employed a technique known as masterly inactivity: they assumed an alert watchfulness, giving the patient the impression, which was false but reassuring, that they would do what had to be done in the event that anything untoward happened. Since most people got better anyway, this seemed to confirm the wisdom of the doctor.

But masterly inactivity

is no way to increase your fee for service or gain a reputation for technical mastery. Patients too prefer to think that they are doing something rather than nothing to preserve themselves. That is why some of them are not merely surprised, but aggrieved when illness strikes them: for they have done all that they were supposed to do to remain in good health, from eating broccoli to regular bowel biopsies.

The lonely bag of muesli

Screen Shot 2015-10-12 at 08.13.01It is, Dalrymple notes,

of the organic variety.

It has remained untouched since sometime last year, when it was

left behind by some guests who were more concerned for the state of their bowels than the aesthetics of their breakfast.

These guests feared that Dalrymple and his wife

did not have a rigorous attitude to the healthiness of our diet.

Harmless futility of alternative medicine

Ayurvedic steam treatment for irritable bowel syndrome

Ayurvedic steam treatment for irritable bowel syndrome

The continued popularity of alternative medicine does not matter, writes Dalrymple. There may be cases

in which a belief in it prevents someone from seeking treatment for a serious but treatable disease, and thereby causes avoidable death. But most believers in alternative medicine also avail themselves of the orthodox variety.

Supposedly healing herbs and minerals

can be poisonous. I have seen people poisoned with lead and arsenic by Ayurvedic practitioners. But these cases are few and far between.

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The number of people saved by alternative medicine

approaches zero,


I have long since ceased to be irritated by the irrationality of others in this matter, for we are all of us irrational about something and all of us in need of consolation at some time or other in our lives.

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Propriety in the evacuation of waste matter



Fæcal physick

Screen Shot 2015-05-30 at 09.06.07Dalrymple comments on a cloacal cure:

I had fondly supposed that medicine had passed what Freud would have called the anal stage. Here is a case in which rationality must overcome revulsion. The raw material is abundant and cheap and not, I presume, under patent.