History and Psychosis

The Scream by Edvard Munch (1893). As the story goes, Edvard was out for a walk shortly after his sister had been committed to an insane asylum. Suddenly, the skies turned red and he sensed ‘a scream’. He depicted this experience of psychosis in his most famous painting.

The crazy thing about psychosis is how misunderstood it is in the popular imagination. What does it mean to have and how do the symptoms manifest?

For those who have been following my blog for years, you’ll have noticed I’ve taken a bit of a hiatus—emerging every so often to post a vulnerable little missive on heartbreak. It shouldn’t be too difficult to piece together the story of what happened, but since then, I’ve kept a promise to that teenager I tutored and subsequently lost when their mother and I were forced to part ways. Back then, I decided to go back to school to earn my degree and eventually become licensed to practice therapy to help others—a goal I had shared with both mother and child. What inspired the change of career path for me was that teenager and the struggles they dealt with while navigating an unsupportive family life as an openly trans kid. Eventually, the pressure and stress of constantly fighting with family led to mental health issues for that teenager which resulted in hospitalization at a psychiatric clinic. There, they shared their experience with symptoms of psychosis with doctors.

Psychosis is defined as an experience that denotes a break from reality–this can range from delusions, hallucinations, and/or bizarre behavior such as disorganized speech. It is a symptom, not a disorder, and can be featured in diagnoses such as Schizophrenia or Major Depressive Disorder. Causes can range from extreme stress, and substance use, to genetic predisposition.

I felt helpless at the time and a little bit scared. What does it mean if someone I love and care about like my own child, hears voices that tell terrible, self-degrading things? What could we do to help? Would they be okay? Part of that promise was doing everything I could to involve myself in uncovering those answers. And though, per their mother, I am not allowed contact with that teenager any longer—I can do everything in my power instead to help those like them. The reason that I have been unable to update this blog is that I have been busy working at a psychiatry clinic since last year and becoming part of the team at our university that specifically treats patients dealing with first-episode psychosis and the research meant to provide hope for the future.

Basically, I’m doing the damn thing. Sempre ❤️

This is, however, my history blog playground for my research dumps where I can humorously recount the things I’ve either taught myself or felt like sharing with the public. Now feels like the perfect time to merge both passions, exploring the presence of psychosis in well-known historical things, events, or people. From the Oracle of Delphi to insanity contextualized historically, to any excuse to write about how much I love Joan of Arc. Famous individuals and artists in history have experienced psychosis and come out making some of the most beloved works in the world…one of them cut his own ear off for good measure too. Many Kings, Queens, and rulers have also suffered and so have others when the consequence of mental illness often leads to wars of succession. Mostly, I hope to also provide a picture of psychosis that is less terrifying–to shed light on its frequency and treat it with the comfort we have in more common mental health struggles like depression. Let’s de-stigmatize. People with psychosis are unwell but they are not inherently dangerous nor should they be treated as such. Let me show you all the brilliant people in history who had it and went on to do extrodinary things, like inventing calculus. Though, I suppose you could say someone would have to be a little mad to make sense of it in the first place.

‘Madness’ in history hadn’t always included the modern concept of psychosis. The term itself was introduced to psychology in the 19th century, and it’s important to remind the audience that some experiences in history will fit the definition of psychosis but may also fall under the umbrella of a cultural or religious phenomenon for some. Think of the prophets and saints, those who prayed and spoke to gods or heard prophecies, or perhaps figures who developed a grandiose view of themselves and thus the confidence to back it (Did Alexander the Great experience psychosis then? Let’s discuss.) Part of this series will be meant to think about the causal relationship between psychosis and ‘normal’ experiences like superstitions and ghost stories. And some of it will be debunking the usual tomfoolery of myths like the Schizophrenogenic Mother or taking a look at the Four Humors theory of the ancient world. Naturally, we’ll need to dismantle ‘hysteria’ and talk about how Nellie Bly should be everyone’s hero. I’ll pick and choose the order, no rhyme or reason most likely, but know that psychosis and mental illness will heavily feature–and we’ll find a way to have some fun with it.

In Vino Veritas: In Wine, There is Truth

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How many of us have woken up the next morning questioning ourselves–“Did I really just do that?” Those drunken speeches in jolly confessional that were regrettably recorded on video, the inebriated passion in the throes of another’s embrace, or phoning your ex while intoxicated to express exactly how you still feel about them. Sure, blame it on the alcohol–most people unwilling to accept personal accountability for their secret thoughts and desires will be the first to do so. It meant nothing, I didn’t mean it. But turns out, people have been using this excuse since the dawn of civilization and ancient historians have been calling us all out since the beginning. Drink up, losers, we’re going truth shopping.

…Then it is that all the secrets of the mind are revealed; one man is heard to disclose the provisions of his will, another lets fall some expression of fatal import, and so fails to keep to himself words which will be sure to come home to him with a cut throat. And how many a man has met his death in this fashion! Indeed, it has become quite a common proverb, that “in wine, there is truth.”

Pliny the Elder, Naturalis Historia (Book 14, Ch. 28 Drunkenness)

Not unsurprising, but we can find allusions to the value of drunk minds speaking sober truths all the way back to the 5th century BC. Herodotus, ever the perennial scholar of cultural practices to gawk at, details a custom observed by the Persians in his Histories. According to him, it was common among the Persians that if there were a judgement to be made about a serious decision, it should first be talked over while completely smashed on wine. Afterwards, the decision would then be reviewed the next morning while sober before anyone made any final approval on the matter. If it all still sounded like a good idea while kneading a hangover headache, the measure passed. The same went for the other way around–anyone with a decent thought in the light of day had to wait for everyone to reconsider it first while drunk, you know, just to make sure. [Herodotus, Histories Book 1, 133.] Anyone envisioning any sort of impracticality with this method should be reminded that these tipsy Persians held down an enormous empire for at least 200 years with much success–and would have gotten away with it too if it weren’t for that meddling Alexander the Great.

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Darius III after that insane flanking maneuver in the Battle of Gaugamela 331 BC

The idea of the truth being found at the bottom of a glass of booze is so pervasive, that some form of In Vino Veritas exists across most cultures around the world in some lyrical thought. “After wine blurts truthful speech”, “What the sober hold in their heart is on the drinker’s tongue”, “A drunken mouth speaks from the bottom of the heart”, the implications here are endless.

When wine enters, secrets are revealed.

Eruvin, Talmud. 65a

So how much honesty really is in the events and words spoken when inhibitions are down, when a person has no reason to stop actions from tumbling out after a tonic of Gin and truth serum? Idioms are one thing, but is there any science or psychological backing to tell us that being an idiot in our drunken moments is exactly who and what we are deep down?

Duh.

Alcohol can’t make you think or feel things

MD Gary L. Malone, Psychiatrist, Is Alcohol a Truth Serum?

One recent psychological study measured the difference between how someone would rate themselves sober versus who they thought they were while drunk…compared to observers who really didn’t notice a change in personality at all between the two states, actually. Except, of course, in being a bit more openly social. Which is exactly the idea behind being more of your true self while intoxicated. [R.P. Winograd, D. Steinley, S.P. Lane, & K.J. Sher 2017]

And despite this, the correlation between using alcohol as ‘an excuse’ for sexual behavior and as a justification for the action itself can be easily measured too–and it turns out, according to this study, a lot of people intentionally use alcohol to lower sexual inhibitions AND to also use it as the blame both before and after the consideration. [T.V. Ven & J. Beck 2009]

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So, no, getting drunk doesn’t make you a different person AND we also know people are intentionally pretending otherwise to justify behavior they would otherwise not want others to assume they were always capable of while sober. What we do know about alcohol’s effects on the brain, however, is that it results in a surge of dopamine and serotonin (feel good hormones) and it also effects the limbic system which is the seat of the brain that aids in behavioral responses to stimuli and is thought of as primal–the part that would result in lowered inhibitions and any ‘fears’ of expressing the true self. [Hackensack Meridian Health] Essentially, alcohol forces us to be in an Eckhart Tolle ‘here and now’ present where impulse control is minimal, everything is keenly felt in the moment, and with the courage to express it without thinking it through.

For once, the ancient wisdom on the matter may actually have some scientific credibility. So next time you’re facing down a person leaning heavy on the self-preservation that comes with denying their intentions last night because they ‘drank too much’ (or if you’re the one in self-denial) you can either point to the PhD’s or long dead scholars of history. In Vino Veritas.

I’m not bitter but the truth is. Or maybe that, too, is the wine.