Which Mental Illness Encompasses This Problem?

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He didn't say that at all... Read his post again.
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.
 
  • #27
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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.

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.
 
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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.

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?
 
  • #29
bobze
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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.

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?
 
  • #30
apeiron
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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.

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 [Broken]

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.

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".
 
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  • #31
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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 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:

Poe said:
a paradoxical something, which we may call perverseness, for want of a more characteristic term. In the sense I intend, it is, in fact, a mobile without motive, a motive not motivirt. Through its promptings we act without comprehensible object; or, if this shall be understood as a contradiction in terms, we may so far modify the proposition as to say, that through its promptings we act, for the reason that we should not. In theory, no reason can be more unreasonable; but, in fact, there is none more strong. With certain minds, under certain conditions, it becomes absolutely irresistible. I am not more certain that I breathe, than that the assurance of the wrong or error of any action is often the one unconquerable force which impels us, and alone impels us to its prosecution. Nor will this overwhelming tendency to do wrong for the wrong's sake, admit of analysis, or resolution into ulterior elements. It is a radical, a primitive impulse – elementary.

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 this manner, at last, I would perpetually catch myself pondering upon my security, and repeating, in a low, undertone, the phrase, “I am safe.”

One day, whilst sauntering along the streets, I arrested myself in the act of murmuring, half aloud, these customary syllables. In a fit of petulance, I remodelled them thus: – “I am safe – I am safe – yes – if I be not fool enough to make open confession!”

No sooner had I spoken these words, than I felt an icy chill creep to my heart. I had had some experience in these fits of perversity, whose nature I have been at some trouble to explain, and I remembered well, that in no instance, I had successfully resisted their attacks. And now my own casual self-suggestion, that I might possibly be fool enough to confess the murder of which I had been guilty, confronted me, as if the very ghost of him whom I had murdered – and beckoned me on to death.

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'.

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?
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.
 
  • #32
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Wegner summarises his theory here... http://www.wjh.harvard.edu/~wegner/seed.htm [Broken]
This one's a lot more wieldy, thanks.
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.
No, it seems to be much more pathological than that in Poe's case. I explained it in more depth just above to bobze.

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.
Yes.
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".
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.
 
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  • #33
apeiron
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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.

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/forums/showthread.php?t=37141 [Broken]

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.
 
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  • #34
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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/forums/showthread.php?t=37141 [Broken]
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:
There is a higher risk of drug addiction among those with any anxiety disorder (possibly as a way of coping with the heightened levels of anxiety), but drug addiction among OCD patients may serve as a type of compulsive behavior and not just as a coping mechanism.
http://en.wikipedia.org/wiki/Obsessive–compulsive_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:

JeffreyMeyers said:
Though we cannot be quite so exact about the origins of Poe's alcoholism, all contemporary accounts agree that he drank and gambled in a joyless, maniacal fashion and tried to get intoxicated in the shortest possible time:

"Poe's passion for strong drink was as marked and peculiar as that for cards. It was not the taste of the beverage that influenced him; without a sip or smack of the mouth he would seize a full glass, without water or sugar, and send it home with a single gulp. This frequently used him up...
Poe was particularly fond of playing cards-Seven Up and Loo being his favorite games. He played in such an impassioned manner as to amount to almost an actual frenzy. All of his card playing and drinking he did under a sudden impulse...He would always seize the tempting glass...and without the least apparent pleasure swallow the contents, never pausing until the last drop had passed his lips. One glass at a time was about all he could take."
-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.

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.
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.)
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.
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.
 
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  • #35
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Interesting article from the University of Maryland Medical System regarding EDGAR ALLAN POE MYSTERY released September 24, 1996:

In an analysis almost 147 years after his death, doctors at the University of Maryland Medical Center believe that writer Edgar Allan Poe may have died as a result of rabies, not from complications of alcoholism. Poe's medical case was reviewed by R. Michael Benitez, M.D., a cardiologist at the University of Maryland Medical Center. His review is published in the September 1996 issue of Maryland Medical Journal.

"No one can say conclusively that Poe died of rabies, since there was no autopsy after his death," says Dr. Benitez, who is also an assistant professor of medicine at the University of Maryland School of Medicine. "But the historical accounts of Poe's condition in the hospital a few days before his death point to a strong possibility that he had rabies."

Poe was 40 years old when he died on October 7, 1849. He had traveled by train from Richmond, Virginia to Baltimore a few days earlier, on September 28. While in Richmond, he had proposed marriage to a woman who would have become his second wife. (His first wife had died). Poe intended to continue on to Philadelphia to finalize some business when he became ill.

[snip]

In his analysis, Dr. Benitez examined all of the possible causes for delirium, which include trauma, vascular disorders in the brain, neurological problems such as epilepsy, and infections. Alcohol withdrawal is also a potential cause of tremors and delirium, and Poe was known to have abused alcohol and opiate drugs. However, the medical records indicate that Poe had abstained from alcohol for six months before his death, and there was no evidence of alcohol use when he was admitted.

"In addition, it is unusual for patients suffering from alcohol withdrawal to become acutely ill, recover for a brief time, and then worsen and die," says Dr. Benitez, who adds that withdrawal from opiates does not produce the same scenario of symptoms as Poe's illness.

Dr. Benitez says in the final stages of rabies, it is common for people to have periods of confusion that come and go, along with wide swings in pulse rate and other body functions, such as respiration and temperature. All of that occurred for Poe, according to medical records kept by Dr. John J. Moran who cared for Poe in his final days. In addition, the median length of survival after the onset of serious symptoms is four days, which is exactly the number of days Poe was hospitalized before his death.

Poe's doctor also wrote that in the hospital, Poe refused alcohol he was offered and drank water only with great difficulty. Dr. Benitez says that seems to be a symptom of hydrophobia, a fear of water, which is a classic sign of rabies.

[snip-please read online]

"Poe's death is one of the most mysterious deaths in literary history, and it provided us with an interesting case in which to discuss many principles of medicine," says Dr. Mackowiak, who runs the weekly Clinical Pathologic Conference at the medical center.

Dr. Mackowiak agrees with Dr. Benitez that rabies was the most likely cause of Poe's death, based on the available evidence.

[snip-please read online]
http://www.umm.edu/news/releases/news-releases-17.htm

Very sad news indeed.
 
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