The Archetypal Significance of Gilgamesh, by Rivkah Scharf Kluger

The Archetypal Significance of Gilgamesh: A Modern Ancient Hero
By Rivkah Scharf Kluger

As a young student of Jung, Kluger was encouraged by her mentor to study the archetypes of the Epic of Gilgamesh. Throughout her career, she gave many lectures on the subject, and was working on this book when she died. This is Kluger’s posthumous opus about the archetypes of Gilgamesh. As you can imagine, this is a very Jungian literary analysis. Her thesis was that the Epic of Gilgamesh was a coming-of-age story in which the character developed became fully aware (or conscious).

In the first part of the story, Gilgamesh has only an id. He is wild – forcing the men to slave night and day on his building projects. Mothers would weep at the untimely deaths of their husbands and sons who had died from overwork. Gilgamesh would rape the maidens. He would ride around on the shoulders of children (how he managed this feat, I don’t know). Enkidu, likewise, was pure id – though in a different sense. He was someone who could run with the animals because he wasn’t yet quite human.

When Enkidu and Gilgamesh met, there was the first inkling of ego – they became conscious that there was something else to their selves besides this wild energy. But even after they fought Humbaba, they were still a little wild. They scorned Ishtar, throwing insults (and bull haunches) at this revered and dangerous goddess. They were aware of their egos – they wanted immortality through glory – but they still had no self-control.

This insult to Ishtar was another step in their development. Ishtar was the mother goddess, as well as the sexual goddess. By insulting her, they separated themselves from their “mother figure,” thus becoming men. Granted, immature men, but men all the same.

After insulting Ishtar and maddening some others of the gods, Enkidu died. Neither Enkidu nor Gilgamesh was ready for this turn. They had not come to grips with the reality of death. In fact, even after Enkidu’s death, Gilgamesh was in denial. He waited for his friend to return until maggots fell out of Enkidu’s nose.

This realization of death was a new step in Gilgamesh’s life. He now needed to discover his superego, which is the part of himself that would moderate the impulses of the id – his child-like, uncontrolled desires – with his ego – the part of him that was aware of the needs of the real world. Basically the superego is his conscience.

He dressed himself as a wild-man, in some ways regressing away from his ego’s consciousness, and went on a quest for immortality. Along the way, he was tested – over and over – by gods and men. They kept telling him to turn back, his quest was pointless. But he passed all of those tests and reached his goal: Utnapishtim, the man who had survived the deluge and achieved immortality. Much to Gilgamesh’s disappointment, Utnaphishtim couldn’t tell Gilgamesh how to become immortal. But he gave Gilgamesh a plant which would restore the youth of whomever ate it.

Instead of eating it right away, Gilgamesh decided to bring it back to his home in Uruk to share with others. Perhaps this was his first glimmer of conscience? But, of course, even this plan failed. A snake found the plant and ate it. Gilgamesh’s journey for immortality had failed. But it was not pointless. Because in that journey, Gilgamesh had gained wisdom. He’d become aware of his conscience. He was fully conscious.

This was a very difficult book for me to read because I’m not very familiar with Jungian literary analysis. In fact, I don’t think I really processed what Kluger was saying until I tried to put it into my own words. Therefore, this book wasn’t very enjoyable to me, and it will not get a very high star rating. That doesn’t mean it wasn’t a good analysis, only that it wasn’t for me.

This is a series of posts about The Epic of Gilgamesh. Here is a list of all posts thus far:

The Epic of Gilgamesh – Analytical Summary

The Epic of Gilgamesh – Historical Background

The Epic of Gilgamesh – Translations

The Gilgamesh Epic and Old Testament Parallels, by Alexander Heidel

The Archetypal Significance of Gilgamesh, by Rivkah Scharf Kluger

Gender Dysphoria – Homosexuality and Transgender

In the past, there was an amazing amount of stigma against homosexuality. King Henry the VIII of England declared “the detestable and abominable vice of buggery” a felony punishable by death. It was not until 1861 that the maximum penalty in England was reduced to 10 years in prison. Similarly, in 1885, when lesbianism was about to be criminalized, Queen Victoria declared lesbianism to be impossible, and therefore there was no point in making a law against it. In the US, the last law prohibiting homosexuality was struck down by the Supreme Court in 2003. As recently as 1973, homosexuality was a diagnosable disorder in the DSM.

However, homosexuality was accepted in non-Western cultures. For instance, in Melanesia, which is a group of islands in the South Pacific, a society called the Sambia believe that semen is important for physical growth, strength, and spirituality. They also believe that the body is only capable of creating a small amount of semen, so they must get the semen from elsewhere. In order to maintain adequate semen levels, boys exchange semen through oral sex. After puberty, the teens can penetrate the younger boys, thus providing them with semen. As the teen ages, he “transforms” into a heterosexual, and ends sexual intercourse with boys after the birth of his first child. Melanesian children who refuse such practices are considered abnormal and are therefore very rare.

Thankfully, Western culture is beginning to accept homosexuality. In the 1960’s gay and lesbian people began to be more active for their rights. Such activist action led to increased brutality of police and homophobic citizens against homosexuals. Most recently, homosexual activity, although still highly stigmatized by some groups, is more widely accepted as within moral boundaries. Same sex marriages have become legal in all 50 states.

Despite the removal of much of the stigma against homosexual people, there is still a shocking amount of stigma against transgender / transsexual people. In fact, trans people are the minority most likely to be killed in the US. As of October 2015, 22 transgender women have been killed in the US. Considering how rare trans people are in the US, these are shocking murder rates.

Again, the stigma against trans people is most pronounced in Western culture. For instance, before being colonized by the British in the 18th century, transsexuals were revered as holy people who could remove the Evil Eye and bless homes and other places. But with the British also came stigma. Now, transsexual women resort mainly to begging and prostitution. (I will review a documentary on this subject on Saturday.)

In the US, transsexuals must jump through many hoops and red tape in order be approved for surgery. It is a several year-long process. The first step is to be diagnosed with “gender dysphoria” – persistent discomfort about one’s biological sex, or the belief that one should be another sex. Gender dysphoria can be diagnosed in children if six of the following characteristics are met: strong desire to be of another gender; a strong preference for cross-dressing in boys; a strong preference for cross-gender rolls; a strong preference for toys, games, and activities associated with the opposite sex; a strong preference for playmates of another gender; in boys, a strong rejection of typically masculine toys and activities; a strong dislike of one’s sexual anatomy; a strong desire for the sex characteristics of the opposite gender.

Generally, boys with gender dysphoria more often turn out to be homosexual than transexual; however, the large majority of adults with gender dysphoria develop this characteristic as a child. Given that most children with gender dysphoria grow into emotionally healthy adults, there is some controversy about the inclusion of child gender dysphoria in the DSM-5. In fact, when children with gender dysphoria are brought in for counselling, it is often the parents who receive the most counseling.

In adults, gender dysphoria can be diagnosed if two of the following traits are present: an incongruence between the person’s sexual gender and his perceived gender; a strong desire to be rid of one’s sex characteristics; a strong desire for the sex characteristics of the opposite sex; a strong desire to be of the other gender; a strong desire to be treated as the other gender; a strong conviction that one has feelings of the other gender.

After an adult is diagnosed with gender dysphoria, he must undergo years of therapy, including a year of living as the other sex. Only after all these years of hard work can the transsexual be approved by insurance for gender reassignment surgery.

Disclaimer: I apologize for the male (or male->female) leaning of this post. I’m making these posts to help me study for my Abnormal Psychology class, and the book was mainly about men on this subject.

This is a series of posts summarizing what I’m learning in my Abnormal Psychology course. Much of the information provided comes from reading my James N. Butcher’s textbook Abnormal Psychology. To read the other posts, follow these links:

The Definition of Abnormal
A History of Abnormal Psychology
Abnormal Psychology in Contemporary Society
Contemporary Viewpoints on Treating Mental Illness – Biology
Contemporary Viewpoints on Treating Mental Illness – Psychology
Frontline: New Asylums
Brave New Films: This is Crazy
Clinical Mental Health Diagnosis: Biological Assessment
Clinical Mental Health Diagnosis: Psychological Assessment
Does the DSM Encourage Overmedication?
Post Traumatic Stress Syndrome – The Basics
Panic Disorder
Obsessive Compulsive Disorder
Hoarding and Body Dysmorphic Disorders
Depression – an Overview
Personality Disorders – Clusters and Dimensions
Personality Disorders – Cluster A
Personality Disorders – Cluster B
Personality Disorders – Cluster C
Biological Effects of Stress on Your Body
Somatic Symptom and Related Disorders
Dissociative Disorders
Borderline Personality Disorder
Dialectical Behavioral Therapy
Paraphilic Disorders
Gender Dysphoria – Homosexuality and Transgender
Anxiety Disorders
Bipolar Disorder – The Basics
Suicide – An Overview

References:

Butcher, James N. Hooley, Jill M. Mineka, Susan. (2014) Chapter 12: Sexual Variance, Abuse, and Dysfunctions. Abnormal Psychology, sixteenth edition (pp. 405-442). Pearson Education Inc.

The Three Sisters, by Sonia Halbach

The Three Sisters (The Krampus Chronicles Book 1), by Sonia Halbach
This book was provided by the publisher through NetGalley in exchange
for a fair and honest review.

Every Christmas Eve, Maggie has the same dream. Santa is walking on the top of her grandfather’s manor, when suddenly he slides off the end. But this year is different. This year, it’s a nightmare in which he is pushed by something sinister. Awakened from her dream, she decides to go sledding – ending up in an accident that leads to meeting the handsome (but older) Henry. Henry has come with strange claims: that Maggie’s grandfather, who is well known for writing the poem ‘Twas the Night Before Christmas, had plagiarized his poem.

While exploring the mansion for proof of plagiarism, Henry and Maggie are accidentally swept into a strange underground village named Poppel – a village strangely resembling Santa’s fabled home. But not all is right in Poppel. It is ruled by tyrants called the Garrison, and Nikolaos is missing. She and Henry must find three hidden objects before the end of Christmas Eve, or else Maggie, Henry and their families are in terrible danger – as is the hidden village of Poppel.

This was a refreshingly unique story based on the poem ‘Twas the Night Before Christmas and Alpine German folklore of the anti-Santa named Krampus. Who knew a world could be built just around such a short poem? And I’d never heard of Krampus before reading this book. (Of course, just yesterday I went to the theaters and found out that a movie named Krampus is soon to be released, though there seems to be no relation between the two.) I really enjoyed reading this book. It was cute, adventurous, and had a tad of romantic tension. And one thing I really loved about this book is that the story was complete at the end. That is the perfect beginning to a series, as far as I’m concerned. I will definitely watch for the next in the series.

4 snowflakes for creativity, action, romance, and fun

Paraphilic Disorders

Paraphilias are sexual behavior patterns in which unusual objects, rituals, or situations are required for full sexual satisfaction. And yes, believe it or not, paraphilic disorders are diagnosable in the DSM-5. But in order to have a disorder, you can’t just be turned on by unusual situations – it has to involve suffering or humiliation of yourself or others. (Though unfortunately, the suffering may be caused by stigma within society.) I will list several paraphilic disorders and discuss each:

Fetishistic Disorder: Individual has recurrent sexually arousing fantasies, urges, and behaviors involving inanimate objects (i.e. women’s underwear) or parts of the body (e.g. feet). People with fetishes are generally men.

Transvestic Disorder: Hetreosexual men who must be wearing women’s clothes in order to experience full sexual experience.

Voyeuristic Disorder: Individuals with voyeuristic disorder have intense sexual fantasies and behaviors of watching women undress or watching the sexual activities of others. People with this disorder are generally young men.

Exhibitionist Disorder: These individuals have intense sexual desire and behavior to sexually expose themselves to others. This generally is a man exposing himself to a young, unsuspecting woman; but sometimes they expose themselves to children.

My dad tells the story that one time he was standing in a check-outline for groceries, and a man laid it all out on the cashier’s countertop. Cool as a cucumber, and without even glancing at the man, she rang up a can of food and then whammed it down hard on…well, you know where. That man was hauled out in an ambulance. Sometimes bad decisions are made.

Frotteuristic Disorder: In frotteuristic disorder, someone is sexually excited by rubbing his genitals against an unwilling participant. I originally became familiar with this one due to a series of incidents (twice involving myself) with a coworker in retail. Very, very gross. Ick. But it was an experience to learn a new word when my dad was like “Oh! there’s a disorder for that!”

Sexual Sadism Disorder: The term “sadism” derives from the Marquis de Sade who got great sexual excitement out of inflicting cruelty upon people. Similarly, an individual with sadism disorder is aroused by psychologically or physically abusing someone. When sadism is inflicted upon a willing participant, it is not considered a disorder. But some sexual sadists inflict it upon partially or fully unwilling people.

Sexual Masochism Disorder: The term “masochism” is based on a fictional character created by Leopold V. Sacher-Masoch. In masochism disorder, an individual must get intense sexual pleasure from fantasizing about or indulging in the experience of pain.

Sado-masochistic relationships can be healthy and cooperative, within reason; however, masochism can lead to humiliating experiences and sometimes death.
This is a series of posts summarizing what I’m learning in my Abnormal Psychology course. Much of the information provided comes from reading my James N. Butcher’s textbook Abnormal Psychology. To read the other posts, follow these links:

The Definition of Abnormal
A History of Abnormal Psychology
Abnormal Psychology in Contemporary Society
Contemporary Viewpoints on Treating Mental Illness – Biology
Contemporary Viewpoints on Treating Mental Illness – Psychology
Frontline: New Asylums
Brave New Films: This is Crazy
Clinical Mental Health Diagnosis: Biological Assessment
Clinical Mental Health Diagnosis: Psychological Assessment
Does the DSM Encourage Overmedication?
Post Traumatic Stress Syndrome – The Basics
Panic Disorder
Obsessive Compulsive Disorder
Hoarding and Body Dysmorphic Disorders
Depression – an Overview
Personality Disorders – Clusters and Dimensions
Personality Disorders – Cluster A
Personality Disorders – Cluster B
Personality Disorders – Cluster C
Biological Effects of Stress on Your Body
Somatic Symptom and Related Disorders
Dissociative Disorders
Borderline Personality Disorder
Dialectical Behavioral Therapy
Paraphilic Disorders
Gender Dysphoria – Homosexuality and Transgender
Anxiety Disorders
Bipolar Disorder – The Basics
Suicide – An Overview

References:

Butcher, James N. Hooley, Jill M. Mineka, Susan. (2014) Chapter 12: Sexual Variance, Abuse, and Dysfunctions. Abnormal Psychology, sixteenth edition (pp. 405-442). Pearson Education Inc.

November 2015 Review

This was a good month. I had three Thanksgiving celebrations: one with my cousins in Iowa, one with my boyfriend’s family, and one with my own family & boyfriend. They were all a wonderful time. I’m pleased with my progress in my Abnormal Psychology class, work is going uneventfully, and I was very active on my blog. I tried to alternate between “lecture” posts and book review posts this month.

I participated in Nonfiction November with the ladies at Doing Dewey, Sophisticated Dorkiness, I’m Lost in Books, and Regular Rumination. During the month, I read 6 nonfiction books (Evil Hours, I am Malala, The Epic of Gilgamesh and Old Testament Parallels, Quiet, and The Archetypal Significance of Gilgamesh) and reviewed 7. I also enjoyed reading science fiction along with Rinn Reads. I was only able to read 2 science fiction books (The Martian and Shada), and review 3.

Next month I’ll be joining the Christmas Spirit Reading Challenge hosted by The Christmas Spirit. So far, my plans are Little Women, by Louisa May Alcott; The Three Sisters, by Sonia Halbach; and The First Christmas, by Marcus Borg. Hopefully I’ll be able to squeeze in some more. You can see other upcoming challenges in my Challenges Tab.

I’ve been having trouble with formatting this month. If I add a link or italicize after-the-fact, it sometimes turns out really big. In past months, I could resize it, but now it won’t let me do that. It’s irritating. Any advice?

Abnormal Psychology Posts:

Depression – an Overview
Personality Disorders – Clusters and Dimensions
Personality Disorders – Cluster A
Personality Disorders – Cluster B
Personality Disorders – Cluster C
The Biological Effects of Anxiety on the Body
Stress and Your Body – An Introduction
Somatic Symptom and Related Disorders
Dissociative Disorders
Borderline Personality Disorder
Dialectical Behavioral Therapy

Book & Movie Reviews:

The Noonday Demon, by Andrew Solomon
Dark Eden, by Chris Beckett
Gilgamesh Translations
The Biology of Desire
The Martian, by Andy Weir
The Gilgamesh Epic and Old Testament Parallels, by Alexander Heidel
Black Five, by J. Lynn Bailey
Crazy: A Father’s Search Through America’s Mental Health Madness, by Pete Earley
Quiet, by Susan Cain
Evil Hours, by David J. Morris
I am Malala, by Malala Yousafzai and Christina Lamb
Shada, by Douglas Adams and Gareth Roberts

Book Completed:

Acquired:

Movies/Shows Watched:

This update is posted to Sunday Salon, Sunday Post @CaffeinatedBookReviewer, Stacking the Shelves @Tynga’sReviews, @MailboxMonday, It’s Monday What are You Reading @BookDate

Shada, by Douglas Adams and Gareth Roberts

Shada: Doctor Who, the Lost Adventure
By Douglas Adams and Gareth Roberts
Narrated by Lalla Ward and John Leeson

Shada is a novel tie-in to the popular TV series Doctor Who. Specifically, it is based on the screenplay (written by Douglas Adams) of an unbroadcast eighth doctor story arc. The Doctor, Romana, and K-9 go to visit an old friend, Professor Chronotis, after receiving a distress signal. It turns out that Chronotis had stolen a dangerous book: The Worshipful and Ancient Law of Gallifrey. All the Time Lords have heard of this book, but none of them quite seem to remember what it’s for. When the book is accidentally borrowed by a post-doc, the Doctor and Romana must find the book and keep it out of the hands of Skagra, an evil genius bent on becoming the universe. (Important distinction here – he’s not taking over the universe; he’s becoming it.)

This is the first time I’ve ever read a novel tie-in to a show or movie. My opinion has always been that books can become movies but movies shouldn’t become books. You have to add in so much information for a TV novelization to be a good book. When I read a book, I’m not just looking for a story, I’m looking for beauty. For art. For characterization. These are things that this book did not particularly have. You knew who the characters were, after all. Why develop them? You knew about the world in which this story was taking place. No need for world building. So, in that way, the book isn’t what I’m generally looking for in a book.

That said, this book did have humor, excitement, and familiar friends going through wild adventures. It was Doctor Who, after all, how could I not like it?

The book was well-read – narrated by the actress who played Romana in the TV show. K-9’s voice was John Leeson, as well. So that was a very nice touch. This is my first time listening to a dramatization with sound effects. I’ve heard multiple-reader dramatizations, but never with footsteps, creaking doors, etc. It was kind of fun. Maybe I’ll try something like this out again.

I’m going to have to give this book 3.5 snowflakes because I prefer books that have more characterization and world-building. But I also recognize that this is not what tv novelizations are meant to have.

Dialectical Behavioral Therapy

To supplement my post about borderline personality disorder (BPD), I’ll comment on a highly effective therapy developed especially for BPD. I, myself, have been through DBT and can attest to its wonderful results. DBT is a modified form of cognitive behavioral therapy (CBT). CBT focuses on addressing cognitive distortions (thoughts that assume negative reasons for a potentially neutral situation) and practicing changing the way you think about the situation. DBT focuses on accepting the way you think, but changing the way you react to the thoughts.

DBT was created by Marsha Linehan for patients with BPD, but is now used for many other disordered patients who suffer from suicidal ideation and self-harm. DBT teaches skills that a person can use to react healthily to difficult emotions.

A dialectic, in the DBT sense, can be represented as a see-saw of extremes, with a healthy center-point. For instance, two state-of-mind extremes include Emotion Mind and Rational Mind. Emotion Mind is when a person’s thoughts and actions are governed entirely by emotions. This could be good – such as when someone is in love – but it is often bad. Too much emotion can lead to inappropriate decisions, behaviors, and unhealthy thoughts.

On the other side of the see-saw, a person might be in Rational Mind. Although this sounds good (and can be good when you are performing highly rational tasks like solving puzzles), it is generally not good to think exclusively in rational mind because you miss emotional components of the situation. For instance, a person who is entirely in rational mind is unable to experience empathy or react appropriately to emotional situations (this is often a complaint made about people with Asperger’s syndrome).

You are somewhere between rational and emotional mind at all times. The middle of the see-saw is called Wise Mind. Here, you can express the right amount of emotion and rational thought to make a clear-headed decision. DBT recognizes that people are often at the extremes of this see-saw, and asks that you use “skills” to move yourself back into Wise Mind before making decisions (such as breaking up with your significant other or self-harming).

Almost every situation has a dialectic see-saw. And according to DBT, it is often best to keep yourself in the middle of the two extremes. The middle would be a compromise. Of course, sometimes compromise is the wrong decision to make (such as when you need to cut ties with an abusive relationship), but compromise is generally best.

Skills that DBT suggest are separated into categories of mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance.

Mindfulness includes: grounding yourself in a situation, for instance, recognizing where you are, what you are doing, and what is going on around you; being nonjudgmental, for instance, one of my employees assumes that when the nurses say “she is awful to work with” that they are talking about her. This is a judgmental thought. To be non-judgmental, she would have to say “well, maybe they’re not talking about me. Why am I assuming they are?”

Interpersonal effectiveness entails balancing your own needs with the needs of others, building relationships, and being in Wise Mind when approaching difficult situations.

Emotion regulation includes being mindful of what emotions you’re feeling; being aware of what you want to do – for instance isolating – and doing the opposite; doing things that make you feel good – like leisure activities – or work that makes you feel accomplished – like writing a blog post; coping ahead, for instance, if I know that I will be upset tomorrow because it’s the anniversary of my mother’s death, I can plan some distracting activities to keep myself from brooding.

Distress tolerance includes distracting yourself when you feel upset; self-soothing by taking a bath or rubbing a smooth stone; and accepting reality.

Yes, all this mindfulness stuff might sound cheesy to a lot of you, but being aware of your emotions and how you’re reacting to them is an amazing way of changing the way you behave – and changing the way you behave can eventually remove your dysfunctional thoughts, as well.

Somatic Symptom and Related Disorders

Somatic symptoms are medical complaints that arise from mental illness. In my experience, such symptoms are shrugged off by the general public as “oh, that’s not a real symptom, it’s just somatic.” Well, let me tell you: the symptoms feel very real to the suffering individual.(Something I learned in my work at a suicide hotline and my own intensive outpatient therapy is that what you feel is a real feeling, regardless of what others say.) And sometimes (in fact, maybe a lot of the time) symptoms are due to a “real” medical problem caused by the mental illness. Read my post about the physiological effects of anxiety if you don’t believe me.

Yes, sometimes the symptoms are explainable by factitious disorder, in which a person consciously produces physical and/or psychological symptoms. Generally in this disorder, a person is not maliciously lying to try to get out of anything, he simply wants the attention that comes with being sick. This could be due to feelings of being ignored or unloved.

And sometimes the symptoms are malingering. In this case, the person is intentionally producing or exaggerating physical symptoms motivated by a wish to get out of something undesirable (such as work, military service, or criminal prosecution). I imagine it is these two types of symptoms that create the stigma surrounding somatic disorder.

In somatic symptom disorders, the patient must find the symptoms so distressing that they get in the way of the person’s ability to function in daily life. The symptoms must have one of the following three features: disproportionate thoughts about the seriousness of one’s symptoms, persistent high level or anxiety about health or symptoms, or excessive time and energy devoted to these symptoms.

Just because you sometimes exaggerate and worry about symptoms does not mean that you have somatic symptom disorder. As pointed out by Dr. Sapolsky in his first lecture n the Teaching Company Course Stress and Your Body, sometimes when you have a big test or presentation or work-related stressor the next day you can’t sleep. You just lie there in bed stressing about the fact that you’re not sleeping. And eventually you might begin to worry about symptoms you are feeling. Your gut is rumbling – maybe you have Chrohn’s disease. You have a headache or an ophthalmic migraine – maybe you have a brain tumor. This exaggeration is due to normal anxiety, and everybody feels it sometimes. In fact, I’m a big sucker for cyberchondria.

People with somatic symptom disorders tend to be female, nonwhite, and less educated than are people with more medically founded symptoms. People with somatic symptom disorder tend to want test after test after test to find the cause of their disorder. If one test is negative, they want another. If the doctor tells them they’re fine, and they don’t need another test, they find a new doctor. This is because they really believe something is seriously wrong with them. They are disappointed when nothing is found. This is in contrast to “normal” people who would rather avoid more tests are are relieved when nothing is found wrong. Or people with factitious disorder or malingering symptoms who seem completely serene by the test results.

Unlike the DSM-5, the DSM-IV separates hyperchondriasis, pain disorder, and conversion disorder. In hyperchondriasis, an individual is overly sensitive to small changes in his body. He might interpret a cough as lung cancer or varicose veins as blood poisoning. Much of his time and energy is exhausted in monitoring his symptoms and talking to his doctor.

In pain disorder, the patient feels pain in one or more body parts. This pain is not intentionally produced or feigned. This pain is really felt by the patient – just as much as pain caused by a physical condition. This pain often causes the patient significant problems in their ability to function in daily life. The resulting social isolation and feelings of uselessness can result in depression, leading to more somatic pain. Luckily pain disorder is easier to treat than hyperchondriasis. The patient can be taught relaxation techniques which reduce the pain, and they can undergo cognitive behavioral therapy to reduce their cognitive response to the pain. Antidepressants also help with the pain.

I find conversion disorder to be the most interesting of the somatic symptoms and related disorders. In conversion disorder, an individual might suddenly become blind, deaf, partially paralyzed, or have pseudoseizures. These symptoms occur during highly stressful situations like combat. Because the individual becomes too stressed to deal with combat, he suddenly becomes blind or partially paralyzed. These symptoms are not faked. The person really believes that he is blind or deaf. However, upon medical examination, people with conversion disorder unconsciously respond to stimulus. They will turn their head in a direction of a noise. They will be able to avoid obstacles while walking.

Conversion disorder is most common in medically unsophisticated individuals. A particularly effective treatment for conversion disorder is to educate the individual about the psychological causes of his disorder. Also, these symptoms often go away after the stress has been reduced significantly.

As mentioned above, factitious disorder is diagnosed when an individual consciously exaggerates her symptoms in order to get attention. This is distinguished from malingering in that she is not trying to get out of work, win a lawsuit, or get other obvious external gains. In popular culture, a form of factitious disorder called Munchausen’s syndrome by proxy is found frequently in books and movies. (In the DSM-5 it’s called “factitious disorder imposed on another” but that’s a boring name.) In this disorder, a caretaker (generally the mother) will invent symptoms in her child in order to get attention for herself. Often, the mother creates symptoms by slowly poisoning their child. Sometimes a child undergoes numerous surgeries to fix the complaint. It is difficult to diagnose and then prove that a mother is intentionally causing a child’s illness. One hint that such a thing is going on is if the child gets sicker after every time the mother is left alone with the child. But a doctor is hesitant to point fingers at the mother because of lawsuits. One way around this is to put a camera in the child’s room.

References:

Butcher, James N. Hooley, Jill M. Mineka, Susan. (2014) Chapter 8: Somatic Symptom and Dissociative Disorders. Abnormal Psychology, sixteenth edition (pp. 264-292). Pearson Education Inc.

I am Malala, by Malala Yousafzai and Christina Lamb

I Am Malala: The Girl who stood up for education and was shot by the Taliban
by Malala Yousafzai and Christina Lamb
narrated by Archie Panjabi

I am Malala is Malala Yousafzai’s memoir about her time in Pakistan promoting education for girls. She begins by discussing her family – from her grandparents, to her parents, and then to herself. She discusses the major political and geological forces that impacted her childhood and led up to her eventually being shot by the Taliban. She finished the book talking about how she felt when she awoke in England not knowing what had happened or where her family was. It is truly an amazing story.

Since I read this book for Non-Fiction November 2015, I will write my review in a different format than usual, by answering a list of questions:

1. What did you think of the tone and style in which I Am Malala was written?

While listening to the book, two things occurred to me. The first is that the tone was a bit naive and honest in the way only a child can be. The types of things she observed, for instance, like how much or less attractive someone was than herself. Their skin color, etc. I realize these things are thought about by adults, but the innocent way she brought them up was darling. I also felt that the way she talked about her competition for being first in class was cute. In an adult that would seem like a lack of humility if talked about with such frequency. But in her, it was sweet.

It also occurred to me that the writing was much too fleshed out to be entirely written by a young teenager. There was some obvious journalistic questioning going on before writing the book – and that is to the benefit of the story, and clearly the work of Christina Lamb.

2. What did you think of the political commentary in the book?

I found the political commentary interesting, especially since I’m only somewhat educated on the subject. The commentary obviously didn’t have the powerful understanding shown in a book like The Kite Runner, by Khaled Hosseini but it showed that Malala was quite intelligent and observant. It was interesting hearing those events from the eyes of a child.

As long as I’m comparing the book to fiction, it reminds me somewhat of In the Country of Men, by Hisam Matar in the sense that it is about “adult” events narrated from the eyes of a child. Of course, there are three major differences: location, fiction/non-fiction, and the age of the author. But still, I think it’s an interesting comparison.

3. Did anything particularly surprise you about Malala’s daily life or culture?

I was surprised to hear how socially active Malala was before she was shot. I assumed the story was about a girl who became active only after she was shot – in other words, that the bullet was random, and that it gave her an opportunity to speak out. But, no, she was from a “privileged” environment (at least at the end) and was shot because she was speaking out.

4. Do you think you would act similarly to Malala in her situation? If you were her parents, would you let her continue to be an activist despite possible danger?

I wouldn’t be as brave as Malala, nor do I think I am as intelligent as Malala. If I were her parents, I would support her doing whatever she felt was best. That’s what my parents always did with me. It’s a great way to let a child grow into her own.

5. What did you think of the book overall?

I do not usually read memoirs – not sure why, I just tend to gravitate towards the heavier non-fiction. But this book was pretty fascinating for me. Malala was so intelligent and perceptive. I loved her voice. (I don’t mean the narrator’s voice, though she did a lovely job.) This book makes me want to read more memoirs.

I would normally give this book 4 stars for writing and interest level, but since it’s such an important topic, it gains an extra star.

Borderline Personality Disorder

Borderline personality disorder (BPD) is in Cluster B, but I didn’t discuss it in my Cluster B post because I think BPD deserves a post of its own. People with BPD have high impulsivity, drastic mood swings, terror of abandonment, and extremely volatile relationships. Such individuals also have self-images that vary significantly from one moment to the next.

Relationships with people with BPD can be very difficult, since these individuals have intense fear of being abandoned. They also have black-and-white thinking. Their loved ones tend to be either placed on an ivory tower or (with only small provocation) viewed a hateful, evil person. This is often seen in relationships with therapists, parents, and significant others. A person with BPD may feel an intense attachment to her therapist, to the point of crossing personal boundaries, and then feel abandoned and hateful when the therapist tries to set clearer boundaries. People with BPD often respond to environmental stimulus in extreme ways, not understanding or caring what the repercussions of their responses might be. In the example of the therapist, a patient who feels abandoned might become violent, verbally abusing the therapist or attacking her physically.

People with BPD often self-harm, and make multiple attempts at suicide. Often, the attempts at suicide can be viewed as a manipulative attempt to get attention, though sometimes the suicide is completed. (After all, the more often someone attempts, the more likely it is that completion will eventually happen.) Patients with BPD can also experience psychotic or dissociative symptoms. They might have hallucinations or paranoia.

BPD often occurs with other disorders – bipolar disorder is very common. I imagine this has a lot to do with the mood swings, impulsivity, and psychotic and dissociative symptoms. As I’ve said in previous posts, I have been diagnosed with both bipolar disorder II and BPD. I am still very skeptical of the BPD diagnosis, because all of my symptoms that fit in the BPD category can be explained by my bipolar disorder – and I don’t have the characteristic difficulty with relationships and fear of abandonment which are so strongly associated with BPD.

Another disorder that often occurs with BPD is PTSD. This is most likely because people with BPD have often gone through traumatic experiences such as sexual, physical, or emotional abuse as a child.

In order to be diagnosed with BPD, an individual must have five or more of the following traits: 1) frantic efforts to avoid real or imagined abandonment; 2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation; 3) identity disturbance – markedly and persistently unstable self-image or sense of self; 4) impulsivity in at least two areas that are potentially self damaging – spending, sex, substance abuse, reckless driving, binge eating; 5) recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior; 6) Affective instability due to a marked reactivity of mood – intense dysphoria, irritability, or anxiety; 7) chronic feelings of emptiness; 8) inappropriate, intense anger or difficulty controlling anger; 9) transient, stress-related paranoid ideation or severe dissociative symptoms.

I have a former friend who has been diagnosed with BPD. She experienced most of these symptoms. One incident that really sticks out in my mind is that when we were going on a distance drive from city-to-city, we stopped at a truck stop along the way. She went into the bathroom, and I stepped into the book shop. When she found me she was frantic – she’d thought I’d abandoned her in the middle of nowhere and that she’d have no way of getting home. At the time I didn’t understand the symptoms of BPD, and I was shocked at her attack. I mean, why on earth would I abandon her in the middle of nowhere? Especially for no reason at all? I told this story to a BPD guest speaker for our class. She laughed and said that her best friend will hop behind an aisle while shopping and she’ll freak out and think he left her. Even though he’s done this many times, she still freaks out every time.

Unfortunately I lost my friend who had BPD. As I said, at the time I didn’t understand BPD. She was having a particularly hard time with her mental illness at the same time that I was having a particularly hard time with my own. We got into fight after fight after fight. Then one day she invited me to a party. I refused – I was isolating because I was very depressed. She decided that I had decided to “friend dump” her and she friend dumped me first. I’ve made several attempts to rekindle the relationship, but it is unfortunately dead.

That brings me to a point that I think is very important. BPD is highly stigmatized in our society. It’s even highly stigmatized among mental health workers – many of whom won’t take more than one BPD patient at a time. There are people who’ll say you should never be friends with someone who had BPD. I think this stigma is tragic. Every person with BPD that I have met was a wonderful person despite their problems. By understanding the symptoms of BPD, and by talking to them about how we should respond when the affected person is in a “mood,” we can have a healthy and wonderful relationship with someone who has BPD.

This is a series of posts summarizing what I’m learning in my Abnormal Psychology course. Much of the information provided comes from reading my James N. Butcher’s textbook Abnormal Psychology. To read the other posts, follow these links:

The Definition of Abnormal
A History of Abnormal Psychology
Abnormal Psychology in Contemporary Society
Contemporary Viewpoints on Treating Mental Illness – Biology
Contemporary Viewpoints on Treating Mental Illness – Psychology
Frontline: New Asylums
Brave New Films: This is Crazy
Clinical Mental Health Diagnosis: Biological Assessment
Clinical Mental Health Diagnosis: Psychological Assessment
Does the DSM Encourage Overmedication?
Post Traumatic Stress Syndrome – The Basics
Panic Disorder
Obsessive Compulsive Disorder
Hoarding and Body Dysmorphic Disorders
Depression – an Overview
Personality Disorders – Clusters and Dimensions
Personality Disorders – Cluster A
Personality Disorders – Cluster B
Personality Disorders – Cluster C
Biological Effects of Stress on Your Body
Somatic Symptom and Related Disorders
Dissociative Disorders
Borderline Personality Disorder
Dialectical Behavioral Therapy
Paraphilic Disorders
Gender Dysphoria – Homosexuality and Transgender
Anxiety Disorders
Bipolar Disorder – The Basics
Suicide – An Overview

References:

Butcher, James N. Hooley, Jill M. Mineka, Susan. (2014) Chapter 10: Personality Disorders. Abnormal Psychology, sixteenth edition (pp. 328-366). Pearson Education Inc.