Which Mental Illness Encompasses This Problem?

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In summary, the conversation discusses the concept of overwhelming compulsion and its effects on individuals, particularly in the cases of Edgar Allan Poe and Derren Brown's experiments. The topic is debated whether it is a part of OCD or a separate condition, with personal experiences and examples being shared. Ultimately, it is concluded that while it may have similarities to OCD, it is not the same disorder and may be a fictional illness.
  • #1
zoobyshoe
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The problem is: the overwhelming compulsion to do something because you know you shouldn't do it.

I'm reading a biography of Edgar Allan Poe and he complains of this compulsion having ruled his life, particularly in the case of his binge drinking.

Derren Brown also exploits this compulsion in one of his segments in which he induces a girl to electrocute a kitten simply by giving her the task of not electrocuting the kitten. (He puts her in a room with a kitten in a metal cage, an on button, and tells her her job is to stay there alone for five minutes without pressing the button.)

I'm thinking this must be a part of OCD or an anxiety disorder, but it might be something else, and I'm too lazy to hunt for it just now.
 
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  • #2
Whatever it is, it has nothing to do with OCD.
 
  • #3
micromass said:
Whatever it is, it has nothing to do with OCD.

Are you sure about that?

Here's a test for you:

Don't think about white bears.
 
  • #4
Illuminerdi said:
Are you sure about that?

Here's a test for you:

Don't think about white bears.

As somebody who suffers from OCD himself, I am quite sure that it has nothing at all to do with OCD. And your example also has nothing to do with OCD.

OCD has to do with frightening or obtrusive thoughts. These thoughts are so disturbing, that you usually feel compelled to do some kind of action to "eliminate" the thought.
That said, everybody has that, but OCDD sufferers have it really bad.

A typical OCD person would think of pushing the button and hurting the poor little cat. But the thought would frighten and disgust him so much that he ends up counting to 1024 (for example). OCD does not make people push the button. Pushing the button is evil and disturbing, and OCD does not drive you to doing evil things.
 
  • #5
Illuminerdi said:
Here's a test for you:

Don't think about white bears.
Hehe, this isn't the same thing. In order not to think about polar bears you have to remember what not to think about. It's a joke catch 22.

As I recall it was the initiation rite of some British men's club. They give you this task, not to think about polar bears, leave you alone for a while, then come back and ask if you thought about polar bears. The right answer is "No", i.e. to pretend you didn't.

It's not impossible to avoid pressing the button at all in the case of the kitten. Certain people are susceptible to the urge to do it strictly because they were told not to. It has something to do with maintaining your autonomy at all costs. They would have no desire to kill the kitten at all. The point is to never let anyone else control you.
 
  • #6
this is not OCD. no anxiety.
OCD is an anxiety disorder.
this can be a fictional illness.
it is not listed in DSM.
 
  • #7
micromass said:
As somebody who suffers from OCD himself, I am quite sure that it has nothing at all to do with OCD. And your example also has nothing to do with OCD.

OCD has to do with frightening or obtrusive thoughts. These thoughts are so disturbing, that you usually feel compelled to do some kind of action to "eliminate" the thought.
That said, everybody has that, but OCDD sufferers have it really bad.

A typical OCD person would think of pushing the button and hurting the poor little cat. But the thought would frighten and disgust him so much that he ends up counting to 1024 (for example). OCD does not make people push the button. Pushing the button is evil and disturbing, and OCD does not drive you to doing evil things.

I agree that it's not OCD, but not that it has nothing to do with OCD. I can say this from personal experience1 as well as someone with a family history that covers half the DSM. The idea is that it's the inability to suppress an unwanted thought, which can become amplified. I know there's some suggestion involved in this particular example which isn't usually the case with OCD (though it is, with the example I'll list below), but it's conceptually similar, even if not directly related.

I personally have sought treatment2 for having compulsions wherein I imagine jumping in front of the trains I take every morning to school. It's not a voluntary thought and it's not a suicidal ideation, either. It's more comparable to the "what if?" thoughts that might intrude atop a tall building. While I wait for the train, I experience psychogenic pain, sweating, heavily breathing, and usually tense up and twitch pretty hard immediately before boarding and living the rest of the day, normally.

1. My official diagnosis is actually autism.
2. It doesn't work.
 
  • #8
Illuminerdi said:
I agree that it's not OCD, but not that it has nothing to do with OCD. I can say this from personal experience1 as well as someone with a family history that covers half the DSM. The idea is that it's the inability to suppress an unwanted thought, which can become amplified. I know there's some suggestion involved in this particular example which isn't usually the case with OCD (though it is, with the example I'll list below), but it's conceptually similar, even if not directly related.

I personally have sought treatment2 for having compulsions wherein I imagine jumping in front of the trains I take every morning to school. It's not a voluntary thought and it's not a suicidal ideation, either. It's more comparable to the "what if?" thoughts that might intrude atop a tall building. While I wait for the train, I experience psychogenic pain, sweating, heavily breathing, and usually tense up and twitch pretty hard immediately before boarding and living the rest of the day, normally.

1. My official diagnosis is actually autism.
2. It doesn't work.
What you're describing sounds similar enough to Poe's compulsions to be a lead. A couple of the characters in his stories have the same sort of panic and struggle not to throw themselves over cliffs. Did the therapist give you a name for this sort of thing?
 
  • #9
zoobyshoe said:
What you're describing sounds similar enough to Poe's compulsions to be a lead. A couple of the characters in his stories have the same sort of panic and struggle not to throw themselves over cliffs. Did the therapist give you a name for this sort of thing?

That looks like OCD. I know cases where people are driving a car and suddenly think that they're going to crash the car on purpose. Everybody has these thoughts usually, butThe OCD people think the thought is so bad that they avoid driving the car in the future. So this type of behaviour fits with OCD.
 
  • #10
micromass said:
That looks like OCD. I know cases where people are driving a car and suddenly think that they're going to crash the car on purpose. Everybody has these thoughts usually, butThe OCD people think the thought is so bad that they avoid driving the car in the future. So this type of behaviour fits with OCD.
O.K. Do you know if there's a name for this particular thing?
 
  • #11
Obsessive (but not a disorder)?
 
  • #12
Pythagorean said:
Obsessive (but not a disorder)?
I think I found it: Intrusive Thoughts

Intrusive thoughts or mental images of killing ones spouse, parent, child, or self.

There are more listed at the site: http://www.peaceofmind.com/symptoms/thoughts/

Edit: They are calling it "Pure Obsessional OCD".
 
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  • #13
Here's Poe's descant on the subject from The Imp of the Perverse:

We stand upon the brink of a precipice. We peer into the abyss – we grow sick and dizzy. Our first impulse is to shrink from the danger. Unaccountably we remain. By slow degrees our sickness, and dizziness, and horror, become merged in a cloud of unnameable feeling. By gradations, still more imperceptible, this cloud assumes shape, as did the vapor from the bottle out of which arose the genius in the Arabian Nights. But out of this our cloud upon the precipice's edge, there grows into palpability, a shape, far more terrible than any genius, or any demon of a tale, and yet it is but a thought, although a fearful one, and one which chills the very marrow of our bones with the fierceness of the delight of its horror. It is merely the idea of what would be our sensations during the sweeping precipitancy of a fall from such a height. And this fall – this rushing annihilation – for the very reason that it involves that one most ghastly and loathsome of all the most ghastly and loathsome images of death and suffering which have ever presented themselves to our imagination – for this very cause do we now the most vividly desire it. And because our reason violently deters us from the brink, therefore, do we the more impetuously approach it. There is no passion in nature so demoniacally impatient, as that of him, who shuddering upon the edge of a precipice, thus meditates a plunge. To indulge for a moment, in any attempt at thought, is to be inevitably lost; for reflection but urges us to forbear, and therefore it is, I say, that we cannot. If there be no friendly arm to check us, or if we fail in a sudden effort to prostrate ourselves backward from the abyss, we plunge, and are destroyed.

Examine these and similar actions as we will, we shall find them resulting solely from the spirit of the Perverse. We perpetrate them merely because we feel that we should not.

http://www.kingkong.demon.co.uk/gsr/impperve.htm
 
  • #14
Its part of the constellation of impulse control disorders. There are a lot. Some are specific (such as stealing), while others involve increased thrill seeking (think about it like a natural high). In terms of neural circuitry and pathophysiology they are somewhat (or thought to be) related to OCD. The mechanism to cope is different however. I don't think they are that well understood and like with other complex mental disorders this falls on the spectrum of human behavior (think some people are bigger thrill seekers than others), however we don't consider them a disorder until they are pathological (ie; causing harm to self or others).

Often they are related to substance abuse and substance abuse in and of itself can kind of be thought of as an acquired impulse control disorder (don't have time to elaborate, but do look into how addiction affects dopaminergic systems in the reward circuitry of the brain--good introduction at wikipedia)
 
  • #15
bobze said:
Its part of the constellation of impulse control disorders. There are a lot. Some are specific (such as stealing), while others involve increased thrill seeking (think about it like a natural high). In terms of neural circuitry and pathophysiology they are somewhat (or thought to be) related to OCD. The mechanism to cope is different however. I don't think they are that well understood and like with other complex mental disorders this falls on the spectrum of human behavior (think some people are bigger thrill seekers than others), however we don't consider them a disorder until they are pathological (ie; causing harm to self or others).

Often they are related to substance abuse and substance abuse in and of itself can kind of be thought of as an acquired impulse control disorder (don't have time to elaborate, but do look into how addiction affects dopaminergic systems in the reward circuitry of the brain--good introduction at wikipedia)
Thanks, bobze. The first wiki article is pretty short. I found some more comprehensive ones on the subject and it seems to fit as well as the "pure-O" explanation.

Poe was a binge drinker, not the type that is always somewhat drunk every day. He could abstain for periods of months, but then, suddenly, he'd drink. Once he got started he might go on a 5 day bender before he stopped. He claimed he got no pleasure whatever from it. Indeed, there are reports of him drinking so much so fast that he'd be passed out in half an hour. Many people saw him take whole glasses of wine in one gulp. He always said he did it because he felt he shouldn't, and that thought, that he shouldn't, is what tantalized him, not being drunk.
 
  • #16
zoobyshoe said:
I think I found it: Intrusive Thoughts.

The root of it is that the brain is wired to respond to the focus of attention with action. So the simple uncomplicated thing is you notice the traffic lights have turned green and you go.

The more complicated thing that brains can do is inhibit action. So the fact we can sit quietly at a red even while we are itching to go, is due to prefrontal control over habitual responses. We can be focused on a possibility - driving away - and yet hold off until the moment is right. Some further thing happens, like the light changing.

What you are talking about is when we become caught up in paying strong attention to something we must absolutely not do - swerve into other cars, jump off buildings, electrocute a cat.

We know that we could just automatically suddenly do these things. All the triggering stimuli are horribly bright in our minds. The edge of the building, the presence of the other cars, the sight of the button. In effect, we are seeing screaming green lights that raises the fear our bodies will suddenly betray us and act. So now we are caught up in a battle to suppress those urges.

An obssessive personality might find it difficult to control their attention enough to just stop noticing the other cars, the edge, etc. But it is actually unlikely they will act out of habit unless they had previously practiced such lethal reactions to these stimuli.

The Derren Brown example you cite - I see he calls it negative suggestion - does not really fit into this explanation for intrusive thoughts.

You seem to be suggesting the girl was showing something a bit more pathological - a bloody mindedness or oppositional defiant disorder. Being told strongly not to do something would make you strongly want to do it.

Well we all feel that too. But the girl, again apparently selected following pre-show quizzing to find susceptible types, would seem to be complying to the unspoken demands of a "hypnotic" situation rather than reacting willfully against an authority figure.

So it is all related to the same basic brain architecture - the interaction between conscious level planning, willing, attending, and habit level acting, executing, responding.

But hypnosis is the opposite of defiance perhaps. It results from allowing someone else to direct your attention and produce responses "out of your control".
 
  • #17
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...
 
  • #18
zoobyshoe said:
The problem is: the overwhelming compulsion to do something because you know you shouldn't do it.

I'm reading a biography of Edgar Allan Poe and he complains of this compulsion having ruled his life, particularly in the case of his binge drinking.

Derren Brown also exploits this compulsion in one of his segments in which he induces a girl to electrocute a kitten simply by giving her the task of not electrocuting the kitten. (He puts her in a room with a kitten in a metal cage, an on button, and tells her her job is to stay there alone for five minutes without pressing the button.)

I'm thinking this must be a part of OCD or an anxiety disorder, but it might be something else, and I'm too lazy to hunt for it just now.


I would call it the power of suggestion.
 
  • #19
AlephZero said:
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...

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.
 
  • #20
apeiron said:
The Derren Brown example you cite - I see he calls it negative suggestion - does not really fit into this explanation for intrusive thoughts.
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.

You seem to be suggesting the girl was showing something a bit more pathological - a bloody mindedness or oppositional defiant disorder. Being told strongly not to do something would make you strongly want to do it.

Well we all feel that too. But the girl, again apparently selected following pre-show quizzing to find susceptible types, would seem to be complying to the unspoken demands of a "hypnotic" situation rather than reacting willfully against an authority figure.
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.
 
  • #21
AlephZero said:
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...
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.

4 “You will not certainly die,” the serpent said to the woman. 5 “For God knows that when you eat from it your eyes will be opened, and you will be like God, knowing good and evil.”

6 When the woman saw that the fruit of the tree was good for food and pleasing to the eye, and also desirable for gaining wisdom, she took some and ate it.

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:

Pandora was deeply saddened by what she had done, and was afraid that she would have to face Zeus' wrath, since she had failed her duty; however, Zeus did not punish Pandora; because he knew this would happen.

This is the Derren Brown video:

https://www.youtube.com/watch?v=YHaFuYZwX2U

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."
 
  • #22
zoobyshoe said:
I'll stop here and see if you agree or not that Impulse Control Disorder probably doesn't apply to Poe.

This discussion from Daniel Wegener is possibly useful.

http://www.wjh.harvard.edu/~wegner/pdfs/Wegner%20Ironic%20Processes%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 :smile:. 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 into 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 learned 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.
 
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  • #23
apeiron said:
This discussion from Daniel Wegener is possibly useful.

http://www.wjh.harvard.edu/~wegner/pdfs/Wegner%20Ironic%20Processes%201994.pdf
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.

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 :smile:. 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.
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.

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 into 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.
Yeah, I agree with this take.

All these different scenarios illustrate the complexity of the mental machinery involved.
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.
 
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  • #24
AlephZero said:
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.

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:

Story Writing

Student can learn story structure from creating their own versions of fairy tales based on the classics. Stories will include a setting, plot, fairy tale characters and some of the elements common to fairy tales such as magic. The writing activity gives students the opportunity to hone their storytelling skills and practice fairy tale writing style. Younger children or children with special needs can create stories using illustrations. The students can share their stories with the class.Read more: Teaching Ideas for Fairy Tales | eHow.com http://www.ehow.com/info_8112853_teaching-ideas-fairy-tales.html#ixzz1w5nUbnw6

Also, many major universities have "Creative Writing" courses wherein you are instructed to write fiction stories. :biggrin: We can't be knocking down "Creative Writing" courses at major universities. :smile: They sure aren't supporting or endorsing mental illness in their students!:biggrin:
 
  • #25
ViewsofMars said:
Please correct me if I'm wrong but you do seem to be implying that mental illness is folk tales, fairy tales, etc.

He didn't say that at all... Read his post again.
 
  • #26
micromass said:
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
ViewsofMars said:
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.
 
  • #28
micromass said:
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
zoobyshoe said:
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
zoobyshoe said:
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

zoobyshoe said:
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 into 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
bobze said:
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
apeiron said:
Wegner summarises his theory here... http://www.wjh.harvard.edu/~wegner/seed.htm
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 into 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
zoobyshoe said:
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

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
apeiron said:
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
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
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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1. What is the definition of mental illness?

Mental illness refers to a wide range of mental health conditions that affect a person's thinking, mood, and behavior. These conditions can cause distress, impair daily functioning, and impact overall well-being.

2. How is mental illness diagnosed?

Mental illness is typically diagnosed through a combination of medical evaluations, psychological assessments, and interviews with the individual and their loved ones. A mental health professional will use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to identify specific symptoms and make a diagnosis.

3. What are some common mental illnesses?

Some common mental illnesses include anxiety disorders, mood disorders (such as depression and bipolar disorder), psychotic disorders (such as schizophrenia), and personality disorders. However, there are many other types of mental illnesses that can affect individuals in different ways.

4. What are the causes of mental illness?

The exact causes of mental illness are not fully understood, but it is believed to be a combination of genetic, environmental, and psychological factors. Traumatic experiences, chronic stress, and imbalances in brain chemicals can also contribute to the development of mental illness.

5. Can mental illness be treated?

Yes, mental illness can be treated through a variety of approaches, including medication, therapy, and lifestyle changes. It is important for individuals to seek help from a mental health professional to develop an individualized treatment plan that addresses their specific needs.

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