Category Archives: depression

The age of emotional incontinence

Lear on the couch

Was the king demented? asks Dalrymple.

If so, was the dementia of the Alzheimer’s, Lewy body, or multi-infarct type? (His variable mental states suggests the second or third.) Or was he depressed, perhaps as the result of an unresolved grief reaction to the death of his wife, mother of his three daughters? This doesn’t seem likely, since he hardly mentions her, perhaps because she died so long before the action of the play starts. Brief psychotic episode, perhaps? Manic depressive psychosis (rapid cycling type)? Or even personality disorder?

They who emote the most are believed to feel the most

For Dalrymple’s money, the critical point is made by the Duke of Kent:

Thy youngest daughter does not love thee least,
Nor are those empty-hearted whose low sound
Reverb no hollowness.

If, says Dalrymple,

Lear had realised this, then none of the tragedy and suffering would have ensued. And here the play speaks to our age: for we live in an age of emotional incontinence, when they who emote the most are believed to feel the most.

Lear and Cordelia, Ford Madox Brown, 1849-54, Tate

Sinister side of Harley Street

Waste of everyone's time

Waste of everyone’s time

In 1960, the doctor-barrister John Havard’s The Detection of Secret Homicide came out, while in 1962 the schoolteacher-novelist Anthony Burgess published A Clockwork Orange, about adolescent violence.

The two themes are combined, Dalrymple writes, in Pamela Hansford Johnson’s An Error of Judgement (1962), in which the patient-narrator consults William Setter, a Harley Street specialist, about

simultaneous pain in his right shoulder and the back of his left knee. Setter tells him he could have a cardiograph if he wanted but this would be a waste of everybody’s time. Having paid his four guineas, the patient-narrator is reassured and feels better. Payment is a wonderful placebo.

Screen Shot 2016-05-07 at 08.02.20

Get over it

Setter

starts a club in Soho where he acts in a Mephistophelean manner to bring strangely assorted people together in a discussion group. He decides to give up medicine in the middle of his career, which was certain to have ended in a knighthood.

Johnson’s novel

casts light on the prescribing habits of the time. When the narrator’s mother-in-law dies, Setter prescribes Dexedrine for the narrator’s wife to help her get over her grief quicker than the Diagnostic and Statistical Manual of the American Psychiatric Association can say depression.

Setter prescribes phenobarbitone three times a day for a young man called Sammy Underwood,

That'll quieten him down

That’ll quieten him down

presumably to quieten him down, for Sammy is not epileptic.

Setter

suspects Sammy of being responsible for the kicking to death of an old inebriate woman.

Sammy is guilty and confesses to Setter,

who comes to the conclusion that Sammy is so lacking in remorse, contrition and conscience that he is likely to do it again. So for the public good and because he has always enjoyed inflicting harm (it is one of his reasons for having gone into medicine in the first place), Setter decides to kill him.

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Just what the doctor ordered

Sammy complains of insomnia

and Setter suggests that he ask his own doctor for some sodium amytal to help. He then suggests a small bottle of brandy to be taken with the pills just to make sure he gets a good night’s sleep, though with the stern warning that Sammy should take no more, absolutely no more, than four-fifths of the bottle.

Setter’s

secret homicide goes undetected.

Screen Shot 2016-05-07 at 07.23.30Screen Shot 2016-05-07 at 07.26.22Screen Shot 2016-05-07 at 07.33.29Screen Shot 2016-05-07 at 09.03.47

I am very corpulent. It’s not my fault

Screen Shot 2015-06-16 at 08.12.19Like my hoarding disorder, my penetration disorder, my caffeine-induced sleep disorder, my sex addiction, my impulse-control disorder, my sexual aversion disorder, my anorexia, my social phobia, my oppositional defiant disorder, my lepidopterophobia, my depression, my hypoactive sexual desire disorder and my gambling disorder, my adiposity is a disease. I blame

  • the food manufacturers
  • my childhood
  • chemical imbalance
  • restaurants. Portions are too big
  • brain scans
  • genes
  • evolution
  • neurochemistry
  • my parents. I hate my parents, don’t you?

Der Amok-Pilot: eine sehr moderne Geschichte

Screen Shot 2015-03-30 at 08.16.34Dalrymple writes that Andreas Lubitz

was not depressed, he was of bad character, for the improvement of which there is no drug. He was an angry narcissist, murderous at least as much as he was suicidal.

Suffering reverses in life, Lubitz

Screen Shot 2015-04-09 at 23.18.38sought revenge on what he thought was an unjust world.

Many people like him who commit suicide, or try to,

imagine a continued shadowy existence after their deaths in which they are able to witness the doleful effects that their death has had on others, and they enjoy the prospect. He didn’t want to slip away quietly, he wanted fame, even if it were only notoriety.

If he had killed himself

Screen Shot 2015-04-09 at 23.05.48by jumping from a building, say, which requires no more courage than crashing an aëroplane, no one would have heard of him.

But now,

after crashing his aëroplane, everyone has heard of him. The 149 people were sacrificed to his wounded vanity and his desire for fame.

Lubitz

was treated as if he were ill, thereby disguising from him his own responsibility for his state of mind.

Screen Shot 2015-04-09 at 23.20.00He was

a narcissist whose sorrows and failures made him vengeful and murderous as well as suicidal. He thirsted for fame, though he had no achievements that entitled him to it, and he was willing to sacrifice 149 others to achieve it.

And he was prescribed

useless drugs that possibly contributed to his aggression.

Amok, according to a recent account, 'is found almost exclusively in men between the ages of 20 and 40. The incidents are characterised by frenzied attacks with kris, pedang or lembing. The assaults are often directed at family members or friends, then extended indiscriminately to others. Whether or not preceded by unusual behaviours (depression, brooding, sakit hati), amok occurs as a sudden outburst resembling a hyperstartle reaction, and amok-runners typically declare amnesia for the duration of the incident. The majority of amok-runners are killed during attempts by others to restrain the murderous rampages; those taken alive may be subjected to execution, imprisonment or institutionalisation in a psychiatric facility.' Sir Hugh Clifford, British Resident in Pahang (1896-1900 and 1901-03), described it as follows: 'Much has been written concerning the acts of homicidal mania called amok, which word in the vernacular means to attack. It was formerly believed that these outbursts were to be attributed to madness pur et simple, and some cases of amok can certainly be traced to this source. These are not, however, in any sense typical, and might equally have been perpetrated by men of another race. The typical amok is usually the result of circumstances which render a Malay desperate. The motive is often inadequate from the point of view of a European, but to the Malay it is sufficient to make him weary of life and anxious to court death. Briefly, where a man of another race might not improbably commit suicide, a Malay runs amok, killing all whom he may meet until he himself is slain.’

Amok, according to a recent account, ‘is found almost exclusively in men between the ages of 20 and 40. The incidents are characterised by frenzied attacks with kris, pedang or lembing. The assaults are often directed at family members or friends, then extended indiscriminately to others. Whether or not preceded by unusual behaviours (depression, brooding, sakit hati), amok occurs as a sudden outburst resembling a hyperstartle reaction, and amok-runners typically declare amnesia for the duration of the incident. The majority of amok-runners are killed during attempts by others to restrain the murderous rampages; those taken alive may be subjected to execution, imprisonment or institutionalisation in a psychiatric facility.’ Sir Hugh Clifford, British Resident in Pahang (1896-1900 and 1901-03), described it as follows: ‘Much has been written concerning the acts of homicidal mania called amok, which word in the vernacular means to attack. It was formerly believed that these outbursts were to be attributed to madness pur et simple, and some cases of amok can certainly be traced to this source. These are not, however, in any sense typical, and might equally have been perpetrated by men of another race. The typical amok is usually the result of circumstances which render a Malay desperate. The motive is often inadequate from the point of view of a European, but to the Malay it is sufficient to make him weary of life and anxious to court death. Briefly, where a man of another race might not improbably commit suicide, a Malay runs amok, killing all whom he may meet until he himself is slain.’

The amok-pilots

February 1982: amok-pilot Seiji Katagiri forces  Japan Airlines flight 350 to crash into Tokyo Bay. 24 deaths

February 1982: amok-pilot Seiji Katagiri forces Japan Airlines flight 350 to crash into Tokyo Bay. Diagnosis: insanity

Amok-pilot Andreas Lubitz forces Germanwings flight 9525 to crash into the French Alps

March 2015: amok-pilot Andreas Lubitz forces Germanwings flight 9525 to crash into the French Alps. Dalrymple’s diagnosis: wounded narcissism and chagrin d’amour

A little more stigma, please

Screen Shot 2015-04-05 at 19.44.37It would have saved the lives snuffed out by this amok-pilot

Andreas Lubitz’s problem, writes Dalrymple, was

one of character rather than of illness.

He was a narcissist whose enthusiasm for fitness was

not for fitness for any end other than a purely self-regarding one. The picture of him out running, pouting as if engaged on something serious and staring ahead with earphones in his ears to exclude the outer world from obtruding on him in his self-absorbed bubble, suggested a man more than usually self-centred.

Screen Shot 2015-04-05 at 17.37.28He is reported to have been

determined to make more of a mark in the world than his native talents would permit, reducing him to the necessity of doing something terrible to catch the attention of the world that he so craved, and no doubt felt that he deserved. For narcissists, anonymity is the worst of fates.

Dalrymple says he cannot help but think that Western culture

is propitious to the promotion of narcissism of the type that I suspect that Lubitz suffered from — or made others suffer from.

Screen Shot 2015-04-05 at 17.36.37Psychiatry

will never make the likes of Lubitz whole. We shall never be putty in technicians’ hands. That is not the same as saying that he should have been allowed to fly aëroplanes. A little more stigma and prejudice would have saved the 149 lives he so egotistically snuffed out.

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All is vanity and vexation of spirit

Screen Shot 2015-05-05 at 08.13.28On the Tennessee Williams character Big Daddy Pollitt:

There is a snobbery attached to lowliness of origins….Big Daddy learns that…success, which has permitted him to dominate…, is powerless against death….Success is…illusory.

Williams, writes Dalrymple,

exposes the…underside of meritocracy….When you fail…you have no one to blame but yourself. It is…better to fail where there is injustice….[Williams] has [an]… unwelcome message for our time, which regards unhappiness as pathological….We are not unhappy any more, but depressed….In the modern world…Big Daddy…would…have been…given antidepressants….[They] wouldn’t have worked…but…they would have prevented…the need to look inwards.