Was blind, but now I see

This article (below) fascinates me. I remember the controversy over "multiple personality disorder" in the '90s and how it was related to childhood sexual abuse. Unfortunately, it spawned innumerable Geraldo Rivera-type TV shows with the most lurid misrepresentations of the disease and its causes, and a flood of books that may or may not have been based in reality. The whole subject (along with "recovered memory", a concept that triggered a World War III in therapy circles) became more and more sensationalized, so that a serious assessment of what was actually going on became almost impossible.

Then, as with so many other controversial phenomena, it virtually disappeared from the public consciousness. A few years ago I saw a bizarre article by one of the authors of The Courage to Heal (the Bible for survivors of childhood sexual abuse) exhorting women to forgive their families, particularly their fathers, and make reparation to them wherever possible. The whole thing reeked of "lawsuit" (another murky and often hateful manifestation of this whole mess).

This was the first time I have read about multiple personality disorder (now called dissociative identity disorder, perhaps to distance it from its Geraldo-esque roots) in years and years. How times change. And things. And public opinion.

The blind woman who switched personalities and could
suddenly see

Hamilton Spectator

By Sarah Kaplan

It had been more than a decade since "B.T." had last seen anything.

After she suffered a traumatic accident as a young woman, doctors diagnosed her with cortical blindness, caused by damage to the visual processing centres in her brain. So she got a Seeing Eye dog to guide her and grew accustomed to the darkness.

Besides, B.T. had other health problems to cope with — namely, more than 10 wildly different personalities that competed for control of her body.

It was while seeking treatment for her dissociative identity disorder that the ability to see suddenly returned. Not to B.T., a 37-year-old German woman. But to a teenage boy she sometimes became.

With therapy, over the course of months, all but two of B.T.'s identities regained their sight. And as B.T. oscillated between identities, her vision flicked on and off like a light switch in her mind. The world would appear, then go dark.

Writing in PsyCh Journal, B.T.'s doctors say that her blindness wasn't caused by brain damage, her original diagnosis. It was instead something more akin to a brain directive, a psychological problem rather than a physiological one.

B.T.'s strange case reveals much about the mind's extraordinary power — how it can control what we see and who we are.

To understand what happened with B.T. (who is identified only by her initials in the journal article), her doctors, German psychologists Hans Strasburger and Bruno Waldvogel, went back to her initial diagnosis of cortical blindness.

Her health records from the time show that she was subjected to a series of vision tests — involving lasers, special glasses, lights shined across a room — all of which demonstrated her apparent blindness. Since there was no damage to her eyes themselves, it was assumed that B.T.'s vision problems must have come from brain damage caused by her accident (the report does not say what exactly happened in the accident).

Waldvogel had no reason to doubt that diagnosis when B.T. was referred to him 13 years later for treatment of dissociative identity disorder, once called multiple personality disorder. B.T. exhibited more than 10 personalities, varying in age, gender, habits and temperament. They even spoke different languages: some communicated only in English, others only in German, some in both. (B.T. had spent time in an English-speaking country as a child but lived in Germany.)

Then, four years into psychotherapy, something strange happened: just after ending a therapy session, while in one of her adolescent male states, B.T. saw a word on the cover of a magazine. It was the first word she had read visually in 17 years.

At first, B.T.'s renewed sight was restricted to recognizing whole words in that one identity. If asked, she couldn't even see the individual letters that made up the words, just the words themselves. But it gradually expanded, first to higher-order visual processes (like reading), then to lower-level ones (like recognizing patterns) until most of her personalities were able to see most of the time. When B.T. alternated between sighted and sightless personalities, her vision switched as well.

That's when Waldvogel began doubting the cause of B.T.'s vision loss. It's unlikely that a brain injury of the kind that can cause cortical blindness would heal instantaneously after such a long time. And even if it did, that didn't explain why B.T.'s vision continued to switch on and off. Clearly something else was going on.

One explanation, that B.T. was "malingering," or lying about her disability, was disproved by an EEG test. When B.T. was in her two blind states, her brain showed none of the electrical responses to visual stimuli that sighted people would display — even though B.T.'s eyes were open and she was looking right at them.

Instead, Waldvogel and Strasburger believe that B.T.'s blindness is psychogenic (psychologically caused, rather than physical). Something happened — perhaps related to her accident — that caused her body to react by cutting out her ability to see. Even now, two of her identities retain that coping mechanism.

"These presumably serve as a possibility for retreat," Strasburger told the neuroscience site Brain Decoder. "In situations that are particularly emotionally intense, the patient occasionally feels the wish to become blind, and thus not 'need to see.'"

It's not actually all that uncommon for people's brains to stop them from seeing, even when their eyes work fine, the researchers say. When your two eyes see slightly different images — when squinting, for example — the brain will cut out one image to keep you from being confused by the contradiction. Your brain also intervenes in visual processing when you focus on particular objects in your field of vision.

Responsibility for the information "gatekeeping" that kept B.T. from seeing everything she looked at may lie with the lateral geniculate nucleus, a sort of neural relay centre that sends visual information down synaptic pathways into the brain's information processors.

Perhaps more interesting than what it says about sight, though, is what B.T.'s story tells us about dissociative identity disorder (DID), the condition apparently at the root of her vision loss.

Though DID has been listed in psychiatry's bible, the Diagnostic and Statistical Manual of Mental Disorders, since 1994 (and was recognized as "multiple personality disorder" for a decade and a half before that), there is still a large amount of skepticism about the diagnosis among experts and patients alike.

For years before it became a psychiatric diagnosis, DID was known along with a host of other psychiatric conditions as "hysteria," a term that gives you a sense of how it and its sufferers were viewed.

Modern critics of the diagnosis point out the absence of consensus on diagnostic criteria and treatment, and blame sensational stories of DID patients like the 1976 TV movie Sybil for creating an "epidemic" of MPD diagnoses. The 1990s saw a spate of lawsuits from patients subjected to dubious treatments for multiple personality disorders they said they didn't have, and many began to believe that DID was not so much treated by psychiatrists but induced by them through the power of suggestion.

At the very least, it's thought that DID may only be a product of fragmentation at high levels of thinking — a breakdown in a brain dealing with complex emotions.

But Strasburger and Waldvogel say their finding is evidence that DID can unfold at a very basic, biological level. After all, it was not just high-level cognitive functions, such as reading, that were affected by B.T.'s condition; even basic things such as depth perception were difficult for her. And B.T.'s doctors could see all of that playing out in her brain right in front of them on the EEG.

The case study shows that DID "is a legitimate psycho-physiologically based syndrome of psychological distress," Dr. Richard P. Kluft, a clinical professor of psychiatry at Temple University School of Medicine, who was not associated with the study, told Brain Decoder.

The condition is not just a product of culture and psychiatrists' suggestions, he said; as in B.T.'s case, it "represents the mind's attempt to compartmentalize its pain."

The Washington Post

(P. S. A word to those who read this. I copy and paste articles only because posting links tends to be a waste of time. Nobody follows them, any more than I do. It's a little different on Facebook because it gives you a preview with a photo, but without that visual cue, people won't click. I'm not complaining because I'm the same way. I want to give credit wherever possible. Clicking on the author's name will take you to the original article. I did not write this! By the way, the Hamilton Spectator didn't write this either. It appeared originally in the Washington Post, and I can't find the name of the author, whom the Spectator didn't feel compelled to list.)

What's under the label

Hey listen.  I have nothing against kids who have major problems "getting help". But what's the help? How competent is it? How medicalized has it become? Isn't it true that (especially in the age of split-second information-sharing) diagnoses can become faddish and even trendy? 

In my day, in the dark ages, we had a few labels too, and they were judgemental and not helpful at all: "slow". "Retarded". "Disobedient". "From a broken home." "Problem child." Now all these have been splintered into multiple diagnostic categories, but instead of having kids sit in the corner, we diagnose and prescribe for them.

This won't be a rant. I'm not against psychiatry or drugs. I'm not against saying, here and now, that when I was finally diagnosed bipolar at FIFTY years of age, and finally put on the right meds (lithium, the most basic treatment for BP) and found a decent shrink, probably the last one in the world, it was nothing short of a breakthrough for me. Decades of painful, sometimes agonizing confusion and pain and being chewed up by a heartless system were finally over. 

I think I began to get well when I began to object. Hey, wait a minute. This drug is making me sick. Hey! I don't think I have a personality disorder. ("How would you know? You have a personality disorder!"). I can argue with my shrink, who by the way is highly critical of the medical/psychiatric community and the way it operates. (This is the only reason I keep going back.) But kids aren't in a position to do this, and their parents are usually completely intimidated by "experts".

I so often hear, in any treatment of any sort of mental illness, how important it is to "get help". The person giving this sage advice, usually a non-professional, can then wash his/her hands of the whole thing. There.  I've said something helpful, haven't I? How could it be wrong to "get help"? Haven't we settled the matter? Why don't you go away now? Your pain and distress are making me extremely uncomfortable. Go get help. Goodbye.


(This could be a whole post on its own, but have you noticed how many articles giving expert advice on psychiatric matters are written by Joe Shmoe, some hack with NO qualifications whatsoever, only misguided opinions and a space to fill on a quasi-medical web site? But people lap this stuff up! It absolutely amazes and appalls me how many people believe practically everything they read. It's as bad as that meaningless phrase, "Statistics show." WHAT statistics? Show me! And even if they do exist, how skewed are they?)

But I digress. There's this term, iatrogenesis, and I like it not only for all those syllables (six!) and its odd look on the page, as if it's starting in the middle, but for its meaning: a condition caused or at least driven by the "cure". After a while it is self-causing and self-perpetuating and attains an awful autonomy. It goes around in endless circles, causing medical people to label it "hypochondria", or maybe even something worse that requires a new kind of medication.

Good help is hard to find.

I won't go into all of my history - I don't go in for that sort of thing, as I think it inspires vampire-like lust in readers, the "oh-poor-thing/thank-God-that-never-happened-to-me" syndrome. I'd rather be wildly admired for my brilliance than felt sorry for any day. It was a mess, a battlefield, one war after another, with long stretches of vibrant life - years, in fact - so that when I had to go back and "get help" once again, the unspoken subtext was, "Didn't you straighten all this out already?" What - you mean you're depressed AGAIN?

I remember seeing a piece in Psychology Today in the early '90s which had a revolutionary article in it with an idea so daring, so controversial that they almost never printed it at all.

Depression is a recurrent condition.

Recurrent?! Meaning: part of the human condition? Meaning (like most things) ongoing? Something you have to deal with each time you get up in the morning?

I thought that was called "life".

Prior to this earthshaking announcement, depression was supposed to be cured "by the book": by reading asinine pop-psychology books, most written by (again) non-professionals. I'm OK, You're OK. How to Be Your Own Best Friend. And (my worst pick of all) The Down Comforter, strongly implying that we really do enjoy wallowing in our depression and don't want to give it up. But I used to think these were sort of like diet books. If it works so goddamn well, why is there another one along a few months later that sells even better?

Anyway, I no longer give a fuck about most of this. I've had to learn to be selfish, though if I had not found real "help" after decades of horrific damage to my self-esteem, my identity and my soul, I might not be here to write this. It was not so many years ago I was seriously planning to jump off a bridge after taking all my meds. (It's always a good idea to commit suicide twice.)  What brought me to this state of despair was not my disease, but the appalling lack of understanding in the medical community of the nature of my problems. The abyss of loneliness was harrowing. As for the "help", there was a sense of "whaaaaat? You're back here again?" (Didn't we just see you fifteen years ago?) 

I really like the way this video is presented: simple, yet incredibly effective. And I am NOT "against" diagnosis or treatment or even drugs, when they are used prudently (and only when the response is positive and helpful. Dump the crappy drugs that don't work and make you feel sick!) But I begin to feel that the medical community is getting farther and farther away from its own humanity. It's convenient to box kids, dump them in a category, dose them. They will trudge into adulthood with their spirits dampened, the label still stuck to them, even if in tatters. Their hopes of ripping off that label to reveal the shining spirit beneath are starting to look depressingly dim.

"You had me at hello"

Visit Margaret's Amazon Author Page!

http://www.amazon.com/-/e/B001K7NGDA

I'm your puppet (short fiction)

 

Human puppet: someone who is easily jerked around by others. Someone who realizes her position in life is always so, so fragile. Someone who gingerly creeps, tippy-toe, tippy-toe, along thin ice at the top of Niagara Falls.

 

She doesn’t know how it got that way, but maybe she does. Right out of the egg? Wrong egg, wrong sperm? Sometimes it seems that way. And it truly does not matter what she had to bear to survive her childhood, to pull herself out of an inferno of post-traumatic stress in her 30s: it has all been reburied, forgotten again, put away. Then there was the alcohol, but we won’t get into that, will we? About how her kids at first felt proud of her for going to AA, for finally getting her act together and not landing in the goddamn hospital with sickening regularity?

 

 

Going to AA wasn’t exactly a picnic, but her kids were there at her cakes, and her daughter even gave her a cake at some point, maybe five years. Who knows what the creep of time brings? A restored life, maybe, spreading out in many directions, being seen almost as normal sometimes, though of course she wasn’t. Only she knew about how the fragments of her life were wired together, held together by main strength and force of will.

 

And then, many years later, when everything exploded and flew to pieces again, it was: sympathy, compassion, love? No: horror, denial, and accusations that she was making the whole thing up. Faking sickness to get attention for some bizarre reason. When the truth was, for most of her life she had been faking health, trying to keep up a mask that looked enough like her that most people were fooled.

 

All right, all people.

 

How is it that you can be married for 40 years and have a spouse who knows absolutely nothing about you? How is it that he can even admit, “look, I learned to tune you out a long time ago for my own survival”? Admitting that what she said was just noise, verbal garbage, narcissism and histrionics in a form that wasn’t even words any more, just a sort of “bluhbluhbluhbluhbluhbluhbluhbluhbluh” that didn’t even go in one ear and out the other, because it never went in one ear to begin with.

 

So he has learned to tune me out “for his own survival”, and he has become extremely good at it, to the point that any time I am in pain or distress, a big soundproof sliding door comes down with a heavy clang.  But what about MY survival? Or have I already died in this family? I try too hard, I know I try too hard with the grandchildren and it is beginning to backfire. I see the hard-eyed looks my children give me, the sense of “what the hell is she up to now?”. I realize the things I love and work so hard at are so incomprehensible them that not only do they not take any interest in them, they don’t even know what planet they are from or why anyone would want to bother with them at all.

 

 

So I am lonely. If I say I am lonely within this family that I co-founded so long ago, the response will be outrage that I would ever accuse them of being so heartless. Lonely?? What are you saying, when we allow you to come to our houses and look after our children, when we give you every chance to make individual gifts by hand for their birthdays (secretly sniggering about it behind my back: “waaaaaaaay too much time on her hands!” - I’ve heard them at it, but mustn’t say anything. Mustn’t.)  How can you be “lonely” unless you’re some kind of freak? Go out and make some friends! Do something normal for a change, stop pretending you’re a “writer” and being so pretentious and unrealistic.

 

She remembers the shrink, a thug who looked like Leonid Brezhnev, who said to her in his thick deep thug voice, “Get a job. Get a job at 7-11 maybe and just do writing as hobby.” If she’d had a gun in her hand his wonderful vocational counselling would have been spurting out the other side of his fucking thug head and splattering the psych ward walls with  brain pulp that had turned out to be a complete waste of time.

 

Thinking about dying is something she has become very good at: she started at maybe age thirteen. Though there have been many fallow periods, even years at a time when it never crossed her mind, it was inevitable that SOMETHING would toss her right back to the beginning again and hold her there until she suffocated. She has come to realize that you must not just think of “a way to do it”. You must choose at least two methods concurrently. Take pills, slash wrists (and if you’re really thoughtful and caring, do it in the bathtub so there will be less mess to clean up. Just turn on the tap, you’re done, no towels spoiled). She saw that YouTube video of the guy jumping off a bridge and thought it was magnificent, but he’d have to be full of pills, a lethal amount, first. A dear friend of hers, incarcerated in a psychiatric ward when his psychic agony began to overflow again, smuggled in pills, took them all, then wandered out in the middle of a blistering winter night, passed out beside the railroad tracks like a bum, and was found frozen stiff the next day, a Bobsicle, doublekilled. Man, he was good! He must have practiced for a long time.

 

 

She wondered about THREE ways, but didn’t know how to juggle it all: slish, slash, I was takin’ a bath; jumping-jack flash, it’s a gas-gas-gas; and she couldn’t think of anything cute and self-concealing for the pills. Suicide was hilariously funny. She could not count the number of times she had made therapists smirk, smile or even bark with laughter. They thought she was funny. Badda-boom! She had trained herself that way all her life, learned in her cradle to be amusing, to be the mascot, to keep her father from murdering her in her bed. She had learned to be witty while her older siblings got her drunk at parties and snickered when they found out their married friends (with their wives in the next room) had groped her in the bathroom.

 

But it’s all in fun, isn’t it? Fun, fun. I was lucky to have those social occasions. So they said to me. I should’ve been grateful. And though for years and years she thought she had escaped those poisonous dynamics, she hadn’t. Once again she was a sharecropper in her own home. All she had was some sort of fragile tenancy that could fall through at any moment. “Oh, massa, don’t sell me down the river!” Bark, bark, oh, that’s so funny! Don’t look at me that way! Stop it, stop looking so hostile, it’s just that you’re funny, that’s all. You’re obviously trying to be funny, so why do you get so hostile when I laugh? You’re very entertaining. Besides which, are you really sure any of this really happened? Your Dad sounds like a pretty swell guy. You’ve heard of false memory syndrome, haven’t you?

 

How could anyone want to keep going, to feel any relish for life, when after years and years of struggling to do reasonably well everything blew apart again and hurled you back four decades into helplessness? How could anyone be “entertaining” when their life was unravelling like a sweater, when they were trying frantically to grab on to  a greasy pole, when some hideous beanstalk or poison tree had suddenly thrust up out of nowhere to blow all order and sanity apart?

 

The most important part of the suicide thing, and the place where nearly everyone falls down, is not letting anyone find you. DON’T do a Marilyn Monroe and get on the phone. DON’T call 9-1-1 because 9-1-1 doesn’t rescue useless pieces of shit that want to die anyway. Sylvia Plath set it up so that someone would find her, but oopsy, doopsy, this was a person who wasn’t very punctual, and on that particular day she was tardy enough to cause Sylvia Plath’s death at 30. Or at least, to not prevent it. Everyone dies anyway. Lots of people die catastrophically every day, accidents, poison, murder. Some die in the womb. We all get erased, then the timer is reset to before we even came on the scene. Click! Isn’t this just speeding it up a little?

 

 

But she doesn’t, not on that particular day anyway, because even though she ceased to believe in a benevolent God a long time ago, she has still not completely dispensed with the fear that there is a hell, that she won’t escape herself at all, that she will be pinned, doomed to drink her own poison for all eternity. Or perhaps watch her family howl and scream with rage: “How could she do this to me?”