the Migraines of
by Dan Kelly
Up to the eighth day of your five allowable sick days? Think it's safe to assume the boss isn't buying the ol' cough-'n'-sneeze-through-a-pillow phone routine? Don't call in sick--call in crazy! In these times of disgruntled workers clocking in with shotguns and downsizing their fellow wage slaves, it's a safe bet that a well-placed declaration of insanity will encourage the boss to keep you as "gruntled" as possible.
But let's suppose he doesn't believe that God told you to catch an afternoon movie; or that flesh-eating skinbugs from Mars are crawling all over you, compelling you to watch Oprah. Well, as always, your good friends at Crank are ready to assist.
Listed in this article are a few of the more bizarre denizens of the world of mental illness. After dazzling the bossman with the following symptoms, don't be surprised if he gives you the whole year off, with pay, just to keep you the hell away.
If someone you know isn't acting quite like themselves, you might think little of it. If everybody you know appears to not be themselves, you could be developing a nasty case of Capgras syndrome. First described in 1923 by French psychiatrists Capgras and Reboul-Lachaux, the syndrome crops up in several varieties.
With a dose of the basic Capgras syndrome, the afflicted believes that either someone or everyone they know has been "replaced," thereupon converting their life into yet another remake of Invasion of the Body Snatchers. Take the example of the fifty-year-old Protestant pastor who developed the creeping paranoia that his wife wasn't who she said she was. So suspicious was he of this stranger in his home, the minister slept with a machete under his pillow, just in case. Eventually, for both his and her safety, he was committed. When confronted with his spouse, the clergyman shrieked, "Who are you? Where's my wife?"
The poor woman insisted she was his wife, but the pastor remained unconvinced. His psychiatrist then made the mistake of pressing the issue. Yes, he told the confused pastor, this was indeed his wife of many years. The pastor thought for a moment, then lunged at her, beating her with a flurry of slaps and punches.
"Now I know who you are!" he raged. "You're the one who's been putting poison in my food!"
The minister was seized, strapped down, and then went away for a while; and there, unfortunately, is where my sources leave off.
Another variation on the syndrome is autoscopy. An autoscopic experience is best likened to seeing a mirror image of yourself, standing in open air. One subject, a thirty-year-old man, had the queer delusion of seeing his own face staring back at him, mimicking his every expression. The man enjoyed "punishing" the offending visage by contorting his face into uncomfortable expressions, which the face was then obligated to match. He could also be found shadowboxing, or rather "mirage-boxing" with the illusory image; pummeling the face before him into a bruised and bloody mess.
Fregoli's delusion delves still deeper into the world of psychotic conspiratorial paranoia. In Fregoli delusion, not only has everyone been replaced, they've been replaced by the same person. To elucidate: your wife, your children, your next door neighbor, Officer Bob down on the corner: they could be themselves today, but tomorrow, they could be him, the guy who's got it in for you (whoever he may be). Fregoli sufferers are apt to live their lives in spy novel fashion, continually changing their routes to confound pursuers, and maintaining constant surveillance on their persecutors, if only to be certain that they don't metamorphize once more.
Cotard's syndrome can take a lot of fun out of the average schizophrenic's life. More accurately, it can take the life out of the average schizophrenic. A somewhat common delusion, Cotard's syndrome convinces the afflicted that they are either dying or already dead. Oftentimes, patients with Cotard's aren't as bothered by being "dead" as you or I might be. In fact, most report having "died" several times in their lives (not so coincidentally before, during or after periods of great emotional trauma).
In a few cases, Cotard's syndrome provides a grotesque twist to Capgras syndrome. In one case study, a schizophrenic gentleman referred to as "Mr. A." not only believed he was dead, but that everyone on the planet was too. Creepier still, the rest of us were real live meat puppets, our skins consisting of chicken flesh and our internal organs of hot dog parts. Not a pretty picture, as author/psychologist Richard Noll points out. The image of rotting wiener automatons slowly peeling apart before Mr. A.'s horrified eyes must make a bad acid trip feel like Caribbean cruise by comparison.
In the case of this little delirium, your humble narrator must confess that he's dug up precious little information. It sounds terribly intriguing, however, as the state's chief characteristic is the delusion that one has been "infested." Infested with what, however, is a matter of conjecture; but my guess is that flesh-eating skinbugs from Mars aren't too far off the mark.
Named after famed 18th century aristocrat and world-class fibber Baron Von Munchausen (see the Terry Gilliam movie for details), this syndrome turns its victims into adept fabulists themselves. Munchausen victims possess a driving need for medical attention, whether it's required or not. Going to elaborate lengths to convince medical personnel that they just know that something is wrong with them, the Munchausen "patient" can have doctors scratching their heads for weeks on end as they attempt to diagnose a disease that isn't there. When the jig is finally up, though, and the patient is dismissed as a malinger, he or she simply moves on to the next hospital or doctor for yet another battery of tests.
Cosmic irony being what it is, Munchausen patients often get what they wish for. Unnecessary tests, treatments and surgery can conjure up horrific results--life-threatening infections and painful amputations are not uncommon. One subject had been exposed to so many X-rays during the course of his "medical career," he developed a nasty case of leukemia for his troubles.
Another subject, a 31-year-old woman, showed up for her appointment with complaints of chills, steady fever, and a splitting headache. As sympathetic doctors and nurses prepared the usual tests, she asked to use the restroom first. She was found dead a few hours later, surrounded by a purseload of antibiotics, laxatives, disinfectant pads, a syringe, and a bag filled with white powder. Did the woman OD on smack or speed? Nope. The poor confused lass had been mainlining cornstarch for so long, it finally dammed up and blocked the blood flow in her arteries.
Other factitious disorder patients, primarily medical personnel--most Munchausen sufferers have had medical training at some time in their lives)--practice the fine art of phlebotomy (i.e. vein-tapping). One woman was known to draw blood from her arm with a syringe, then swallow it, thus jerry-rigging herself to vomit plasma on command. Another would withdraw as much blood as she deemed necessary to "relax," flushing the results down the toilet (she "relaxed" herself into a life-threatening case of anemia as a result). Other queasy practices include overdosing on aspirin to develop internal bleeding; gobbling down rat poison, which poisons rat and patient both with warfarin, an anticoagulant; and, in the ultimate bit of idiocy, forcing a knitting needle up one's bunghole so as to lacerate one's colon, thereby ensuring bloody bowel movements for weeks to come. Jeesh. and I always thought blood pudding was consumed, not expelled.
Munchausen Syndrome by Proxy (MSP), on the other hand, spares the patient from the above nastiness. MSP primarily afflicts women with children who seem to get sick a little too often. Yep, despite constant visits to the doctor, hospital or emergency room, the children of MSP patients foster perpetual, undiagnosable upset tummies, skin lesions and/or bloodied stools, among other unpleasantness.
Small wonder. MSP mothers have such a jones for the warm fuzzy feeling they get when everyone tells them what conscientious parents they are, they do everything they can to make damned sure Junior never gets back up to snuff. Injecting their kids with shit, piss and saliva; cutting their milk and cookies with everything in the medical cabinet; sticking them with needles and pins or gouging out pimples and scabs with their fingernails; withholding food and water; strangling the little buggers until they pass out; and cutting off the blood flow to their tiny little brains, so as to induce "epilepsy" are just a few of the tricks that MSP moms employ to keep their kidlings hospital-bound, and themselves on the "Mom of the Year" pedestal. At least until the doctors put two and two together, and mumsy dearest is up on child abuse charges.
A disorder so positively banal in its way, everyone seems to think they have OCD in some small measure. Bringing up the disorder in conversation usually provokes a "can-you-top-this" competition among those present, re: their personal obsessions with numbers, food, grooming, and so forth. True, everyone has their amusing quirks, but hardcore OCD cases aren't composed so much of humorous little twitches than numbingly pathetic, life-ruining exercises in futility.
Hand washing is by far the most common manifestation of OCD. Patients spend hours at the sink, washing their hands to flush away germs, viruses, feelings of stickiness and plain old dirt. Some, in their zeal to achieve perfect sterility, give up on soap and water, switching to Top Job, Mr. Clean, and other industrial cleansers. Their hands get clean all right--so clean, they bleed. Out, damn spot, indeed!
Other OCD patients become obsessed with numbers: counting off every step, chew, blink, street lamp or fence post they pass, "knowing" that if they don't, some terrible, inexplicable, indefinable thing might happen. Others are compelled to keep their homes neat and clean; so neat and clean, they lose their jobs or spouses as they spend hours, days, or weeks making sure everything is just-so. In still another manifestation, one patient would become "stuck" halfway through any doorway he passed through. If a friend or family member didn't happen along to push him through, he'd stand in the doorway for hours, staring up at its right-hand corner to make absolu-positively, without a doubt, for damn sure certain that he was negotiating his entrance properly.
Another bizarre OCD practice, found mostly in women, is trichotillomania--obsessive hair-pulling. These women don't simply twist or twirl their flowing locks, but yank it out wholesale, roots and all. Inveterate trichotillomaniacs can raze their entire bodies of scalp hair, eyebrows, eyelashes, pubic and body hair, strictly through unmindful plucking. One subject, in fact, developed an overwhelming desire to keep her eyelashes and eyebrows in perfect balance. After tweezing them to oblivion, she achieved her ideal through the miracle of false eyelashes and eyebrow pencil. Beneath it all, however, she was as bald as an egg.
Trichophagy adds a disgusting spin on the plucking compulsion by causing the afflicted not only to yank out her hair, but eat it as well. In 1986, Iranian surgeons removed a 4.4-pound hairball from the stomach of a twenty-four-year-old woman who had been gobbling the stuff down for over twenty years. And you thought your cat could cough up some nastiness!
BIBLIOGRAPHY AND SUGGESTED READINGS
Baur, Susan, The Dinosaur Man: Tales of Madness and Enchantment from the Back Ward, New York, Edward Burlingame Books, 1991. (Mawkish pap that canonizes the insane. Nice schizophrenic dialogues, though.)
Feldman, M.D., and Charles V. Ford, M.D., Marc, Patient or Pretender: Inside the Strange World of Factitious Disorders, New York, John Wiley & Sons, Inc., 1994. (TV news magazine paraded pop-psych. Fairly compelling, sometimes grisly, tales of Munchausen syndrome patients.)
Franzini and John M. Grossberg, Louis, Eccentric & Bizarre Behaviors, New York, John Wiley & Sons, Inc., 1995. (In the intro, Franzini and Grossberg claim that they "tried to emphasize that you will be reading about human beings, not 'patients' or 'cases' or 'diagnoses.'" What they meant to say is that this book is a frag grenade of mental mindfuckery. Amazing bits on the above subjects, in addition to necrophilia, frottage, autoerotic asphyxia, and more.)
Noll, Richard, Bizarre Diseases of the Mind, New York, Berkley, 1990. (Trifle. A spottier version of the above book, but entertaining nonetheless.)
Prins, Herschel, Bizarre Behaviors: Boundaries of Psychiatric Disorder, New York, Routledge, 1990. (Accessible, but a tad highbrow. Strangely, all these books have a fascination with references to Shakespeare, Victor Hugo, Robert Louis Stevenson, and other literary bigwigs. Trying to make that English minor pay off, eh boys?)
Rapoport, M.D., Judith L., The Boy Who Couldn't Stop Washing, New York, E.P. Dutton, 1989. (Incredible, braincrunching tales of OCD patients. I've barely scratched the surface in this article.)
Sacks, Oliver, The Man Who Mistook His Wife for a Hat and Other Clinical Tales, New York, Harper Perennial, 1990. (Highly recommended; no library should be without it. L-dopa fix me, all right.)
Tips for that