Which Mental Illness Encompasses This Problem?

ImaLooser

I would call it the power of suggestion.

ImaLooser

Yes, the classic one might be the story of Bluebeard. You could call it Bluebeard Syndrome. Maybe Phizer can come up with an expensive pill for it.

I once saw a Tamil movie in which the hero gets taken up to heaven by a goddess. He gets shown a door and told to never enter it. After having beaten up the god of Death he goes back to the door alone. Then he turns around and walks away. I thought that was SO cool.

zoobyshoe

I think you're right.

My goal here is to figure out what was going on with Poe and to name it in modern psychological/psychiatric terms.

In the story I linked to, The Imp of the Perverse, he is very articulate but he's describing this from scratch with no body of psychological/psychiatric rigor to draw on, because there was no such discipline in place at the time (1845). He is left having to allude to, but dispute, phrenology, the only thing there was in his day that made claims to having sorted any of this out. That being the case, I am extremely impressed by his powers of self-examination and ability to articulate his experience.

However, he seems to fit into an area of Psychiatry I'm not all that conversant with, so I'm inviting others to be a sounding board for me.

I am glad you brought up Oppositional Defiant Disorder. It's the third dynamic that has to be considered in sorting this out.

The list is now:

1.) Pure OCD

2.) Impulse Control Disorder

3.) Oppositional Defiant Disorder

Number 2 is the one I most suspect applies least to Poe. In this disorder the person's internal censor simply fails to kick in. There is no struggle to control themselves: they have an impulse, they act on it. Phineas Gage. The brain circuit that would normally warn them an action might be dangerous or wrong is simply not operating.

I'll stop here and see if you agree or not that Impulse Control Disorder probably doesn't apply to Poe.

zoobyshoe

It can be separated into different classes, though. The Genesis story is more about falling prey to a sociopath than about disobedience. Adam and Eve were completely fine with the prohibition until the smooth talking third party persuaded them otherwise.

This is quite a bit different than disobeying an order because you don't want some monkey on your back giving you orders. In Oppositional Defiance Disorder, anyone who gives you an order is perceived as merely trying to control you.

Pandora's Box is about yet a third dynamic. She was quite simply overwhelmed by curiosity, not the desire to disobey Zeus:

This is the Derren Brown video:



Jump forward to 6:25, and we see a segment where small kids succumb to opening the box very much like Pandora, out of overwhelming curiosity. The task of sitting with the box right there in front of them, nothing else to think about or do, is too much for them.

That's followed by a segment showing a bunch of adults unable to resist looking through a hole in a fence surmounted by a sign saying, "Do Not Look Through This Hole."

apeiron

This discussion from Daniel Wegener is possibly useful.

http://www.wjh.harvard.edu/~wegner/p...ses%201994.pdf

But having watched that Derren Brown clip, what was going on there looks more like a case of straight suggestion.

Note the way Brown kept banging the table and clicking his pen - clearly this was about implanting the urge to hit the button, creating a non-verbal kinesthetic image that would sit separately from the verbal command not to push the button.

So the girl is conflicted by two competing ideas. And the suggestion to "be mischevous", along with the fact that the whole set-up was deliberately disorienting and unreal, creates a permissive context,

The fact that she did push the button was remarkable - I know I wouldn't . The way the tension built up on her face as the clock ticked down shows there was an actual conflict of ideas. And being presumably chosen as one of the highly suggestible 10 per cent, the implanted idea won out over the verbal command.

The kids failing the pop-up box test, and adults the don't look here test, seem different again as this would be simply curiosity getting the better of them. So no different from giving in to the temptation of a drink or a chocolate. Satisfying the itch of curiosity is rewarding. And we often choose short-term gratification over longer-term rationalisation.

I wouldn't really call this an impulse control failure either as the decision is a straightforward balancing of a significant reward that is close at hand against punishing consequences that are judged to be either small or remote.

All these different scenarios illustrate the complexity of the mental machinery involved.

Take Wegner's mention of Baudouin's law of reversed effort. I've learnt from bitter experience on the mountain bike trail that the way to avoid big rocks and rutted corners is absolutely not to look at the hazards. Look ahead to the clear path where you want to emerge. Fill your motor pathways with the right target information because they are trained to aim for where you attend.

zoobyshoe

I read the abstract at the top and the first paragraph. Very interesting to see someone use Poe's observation as a springboard. It's an awfully long paper, though, and if there's something in particular you think I should look at I'd be grateful if you just quoted it here.

I wish they had interviewed her afterward and asked why she thought she ended up pushing it.

What he said toward the beginning is that he selected her because she demonstrated a tendency to be self-critical. This suggest to me that he was hoping to get her ruminating on, and eventually believing, the notion she couldn't pass this "test", to criticize herself to the point she had to relieve the tension by intentionally failing it and getting it over with. It's not clear from the video that's what he did, though, but it might have been too subtle to catch. The things that read to the audience as suggestions are the ones you pointed out.

Extending your observation he created a permissive atmosphere:

He advises her not to play with the cat, to think about something else. He actually sets her the task of drawing to get her mind off it. She draws a cat, thereby defying his advice. To my surprise, he approved of the drawing. But, approving of her rejecting his advice tells her he will approve if she also presses the button. I think that's how that went down, anyway. I wonder how confident he was that she would draw a cat. I suspect he was 80% sure.

Yeah, I agree with this take.

Yes.

I'm intrigued to uncover why it becomes pathologically intense, as in Poe's case. He tended to fall off the wagon right at the critical points when that would do the most damage, when months of sobriety has started to pay off and things were looking up. These are the times he'd be most likely to say to himself, "Everything's looking good and will proceed nicely - if I don't start drinking again." Which thought would torment him until it drove him to a bar.

ViewsofMars

Please correct me if I'm wrong but you do seem to be implying that mental illness is folk tales, fairy tales, etc. Just a warning if that is the case, children in elementary schools are encouraged to write fairy tales:

Also, many major universities have "Creative Writing" courses wherein you are instructed to write fiction stories. We can't be knocking down "Creative Writing" courses at major universities. They sure aren't supporting or endorsing mental illness in their students!

micromass

He didn't say that at all... Read his post again.

ViewsofMars

That is your opinion. The topic is "Which Mental Illness Encompasses This Problem."

AlephZero, said at the top of the page under the title without quoting anyone, "Whatever it's called, judging by the contents of folk tales, fairy stories, etc from all over the world it's a very common human condition. Disobeying an "arbitrary" order not to do something occurs often as a plot device.

Arguably the first recorded example is in Genesis chapter 3... "

AlephZero implies such as I noted in my previous post wherein I wanted to make clear that it isn't often times total fiction. Creative writing courses take fiction to mean objective reality but not yet experienced by the writer. I hope that helps.

micromass

I'm not sure whether you're serious or not.
It's pretty clear that AlephZero never said that mental illnesses weren't real or that they are fairy tales.
He merely said that mental illnesses are often documented in fairy tales or folk tales. For example, there might be a folk tale about somebody who has paranoia. That doesn't mean paranoia isn't real.

ViewsofMars

Do you think it wise to speak on behalf of AlephZero? Which fairy tales and folk tales document mental illness? I'm not aware that Science uses fairy tales and folk tales. Do you have any peer-reviewed journals such as Nature or Science (AAAS) that have articles that support your claim?

bobze

Binge drinking repeatedly would be an impulse control disorder. Again, its more of a spectrum that can encompass a number of things. For instance bulimia is also technically an impulse control disorder.

So Poe's inability to refrain from a behavior (binge drinking) would be a problem of impulse. It isn't necessarily that "warning circuitry" is absent (in some types of ICD it is, but in not all).


I haven't been really following the other discussion of the little girl. But oppositional defiant disorders is defiant behaviors towards authorities with absence of violations of serious social norms. Contrast to conduct disorder (antisocial personality disorder for peoples less than 18), you have frank disregard for social norms and the rights of others (people and animals).

On the other hand (again I didn't read the full story about the girl, so maybe I got the experiment wrong)--sometimes people are just curious in morbid ways. How old was the girl?

apeiron

The PDF is not cut and pasteable. But it does review a variety of studies and theories to do with impulse control.

The area you are interested in is Wegner's speciality. You could even ask him for his diagnosis of Poe.

I find his actual mechanistic explanation rather too, well, mechanistic. But it does get at what is going on all the same.

If you are actively trying to suppress some thought/action, you are going to find it tiring and itself a distracting activity. This leads to "ironic" outcomes.

Wegner summarises his theory here... http://www.wjh.harvard.edu/~wegner/seed.htm

I'm not familiar enough with Poe's story to know, but is this not a simple mental reaction?

If you are struggling hard for a long time to suppress an addiction, then at some point you just want to relax and give in to it. The punishing effects of continuing to struggle versus the rewarding effects of just heading for the bar will seem a rational choice.

So it would be the thought of "being good" and what a strain that will continue to be that makes it sensible to get rid of the reason for making that effort by falling off the wagon.

This would make it different from a true impulse control failure, as can happen with orbital-frontal lobe damage where there just is no higher level monitoring/censoring activity going on.

Giving in can be a rationally thought through response that weighs the pain/reward of conflicting courses of action. As Wegner says, it is ironic that it is the effort involved in being good that eventually becomes the distraction, the interference, the source of negative reinforcement. Making the obvious solution: "stop being good".

zoobyshoe

I agree it would be a problem of impulse. Those articles on Impulse Control Disorder point out, though, that problems of impulse arise in a lot of disorders without being cases of Impulse Control Disorder. This muddies the water and makes it difficult to confidently say Poe's problem was Impulse Control Disorder. The same list is repeated in each article: "intermittent explosive disorder, kleptomania, pyromania, compulsive gambling and trichotillomania". Connections to alcohol abuse are mentioned as merely suspected, possible.

For simplicities sake, I might say his problem was simply Substance Abuse Disorder and leave it at that. In Poe's case, though, there is a whole different mental dynamic behind the drinking. He is not tempted by the pleasure of being drunk, forgetting his problems, easing the stress, etc. The temptation is much more like:

http://www.kingkong.demon.co.uk/gsr/impperve.htm

He's talking about things in the class of the pathological compulsion to throw oneself over a cliff or in front of a train.

In the story, the narrator has gotten away with murder. No one remotely suspects him. However:

In the end he can't resist the compulsion to confess simply because it's the one thing that would most ruin his situation. It does, he ends up in jail awaiting execution.

Poe emphasizes the perverse factor: the action is contemplated precisely because it is the wrong one for your purposes. If you're in Indianapolis and you want to go to N.Y. it's obvious you should go East. Poe would, therefore, feel a compulsion to go West.

Tesla had a rule-of-thumb personal ethic that reminds me of this. He felt that, when you wanted to do something, anything, you should hold that desire at bay and do almost anything else but what you wanted to do. It was a kind of constant, rigorous exercise of his capacity for delayed gratification. However, it manifested as, it probably was, Obsessive-Compulsive Personality Disorder. He couldn't just walk home from a restaurant. He had to pick a block and walk around it three times to delay his getting home, avoid doing what he wanted to do. Making things much harder than they needed to be, delaying the gratification, became outright perverse in his case in many instances. Poe seems to have taken the same thing to it's ultimate end: 'don't merely make a thing much harder than it needs to be; go all the way and outright destroy your chances of arriving at what you want'.

The Derren Brown segment we're talking about is posted in my response to AlephZero. It's actually spread out over three YouTube videos, so it's unfortunately long. The girl is college aged.

zoobyshoe

This one's a lot more wieldy, thanks.
No, it seems to be much more pathological than that in Poe's case. I explained it in more depth just above to bobze.

Yes.
Yes, absolutely, but In Poe's case it seems to be a different animal. The Imp of the Perverse is pretty short if you want to read it. I think it's his best story, actually. Whenever, elsewhere, he discusses his drinking, you get echos of the explanation/logic he uses in this story. Particularly interesting is his claim that he did not enjoy the feeling of being drunk at all. He seemed to get hypnotized by the fact of a course of action being exactly the opposite of what he wanted and was eventually compelled to do it. He's at a complete loss to identify the reward.

I might try asking Wegner, but I should probably read the 20 page paper first.

apeiron

So the imp story is about the urge to confess, and this seems to be quite a typical OCD symptom...
http://ocd.stanford.edu/about/symptoms.html
http://www.stuckinadoorway.org/forum...ad.php?t=37141

Again, I would speculate that is this still more likely to be a tale of misplaced rationality than a less explicable perverseness.

If you are anxious about being found out, and that becomes a dominating fear, then how else can you relieve that fear apart from actually being found out? So if you are anxiety prone, confessing would become quite rational.

Poe's story about the imp seems somewhat different from this other problem of falling off the wagon. There I am sure the drinking had some anticipated immediate reward that outweighed the longer term negative judgement. Going along with the fact that ending an effort not to drink is also immediately rewarding.

When the worst happens, you know things can't then actually get worse. Which might seem an attractive proposition at times.

Poe does seem to be tapping into a rich vein of psychological mechanism - the many ways in which long term and short term thinking can be in conflict. But I don't yet see that he is identifying some particular syndrome that is a recognised mental illness.

zoobyshoe

Thanks for finding these links. They're pretty interesting and informative.

You can see from the testimony of the sufferers at your second link that what is compelling them to confess is extreme guilt. They are obsessed with the idea they have done something very bad, and feel compelled to find some relief from that by making a confession to someone.

This isn't the case in The Imp of the Perverse. The narrator doesn't feel the least bit guilty about the murder. He is self-congratulatory and gleeful about having gotten away with it:

"It is inconceivable how rich a sentiment of satisfaction arose in my bosom as I reflected upon my absolute security. For a very long period of time, I was accustomed to revel in this sentiment. It afforded me more real delight than all the mere worldly advantages accruing from my sin."

The character's urge to confess isn't motivated by guilt but by the irrational urge to harm himself, to destroy his position of safety. We know this because he says so. He explains that urge toward the beginning of the tale in great detail using three different examples of other situations where he's had this urge, and acted on it. This urge to harm oneself is also part of OCD, one of the common "intrusive thoughts". Because of the particular circumstances of the character, his urge to confess (which would ruin his life) is actually a manifestation of the OCD urge to harm oneself rather than the OCD urge to confess.


I found a sentence in the Wikipedia article on OCD that I missed the first read through:
http://en.wikipedia.org/wiki/Obsessi...lsive_disorder

The underlining is by me in order to call your attention to this dynamic, which is different that 'ordinary' drug addiction. Rather than falling off the wagon for the reward of relaxing the effort not to drink, as you suggest, I suspect it was part of the urge to harm himself. Here's a quote from the biography I just read:

-Edgar Allan Poe, by Jeffrey Meyers, p.25
(Meyers is quoting one of Poe's college mates. This problem first manifested itself when he went to college.)

There are quotes from Poe, himself, in the book, asserting he did not enjoy drinking at all. This forcing himself to drink the whole glass in one gulp sounds like the action of a person drinking something they don't want to drink.

The problem with all you suggest here is that it ignores what Poe, himself says, both in the story and when discussing his drinking. You seem to be making the assumption that he wasn't describing the problem accurately and you're 'helping' him by giving a more understandable, conventional explanation. I, for my part, am hearing him describe something I've never experienced and can't claim to fully understand. (I'm actually very fond of the feeling of being drunk. What drove me onto the wagon was the hangovers.)
It really sounds to me like what some of the sites have nicknamed "Pure" OCD. I need to find some follow up literature on drug use as an OCD compulsion rather than a coping mechanism.