Brian Altonen, MPH, MS

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From Psychic to Psychiatric

Psychiatry is very much an attempt of medical practitioners to link human thought and behavior with the physical sciences.  A thought is a decision that is made based upon anything and everything possibly linked to the matter at hand.  It is a mindful activity that is a reaction to and has consequences involving the physical world.   We are alert to the world around us through our mind and react to the events taking place in various ways.  In general, these mind-related activities include the realization that a particular event has taken place which in turn incites deductive and inductive reasoning, which in turn lead to a physical or emotional reaction to the event.  For example, walking through a forest we may see the wind blow, hear a cracking sound, and then realize due to past experiences that this is probably something like a tree breaking, and so realize  ‘I am about to be struck in the head if  I am not careful’, become more attentive to our surroundings, and in the end, successfully avoid a falling tree branch.  However, whenever there are events which we cannot attach a line of reasoning to through prior experience, imagination takes over and something as simple as the unique, one-of-a-kind sound of some howling wind causes us to develop in our mind a picture of what it could relate to, such as a unique piece of terrain or a unique type of animal howling, or worse.

As for the sensations and events that take place within our bodies whenever these events happen, we allow much the same to take place, but assign unique reasons for why we are reacting the way we do.  We base this reasoning on very little experience, and more on speculation as to how the inner workings of our body relate to the environment around us.  This leads us to come up with some unique ideologies and in turn personal states or being, bodily condition, and when a religious or medical leader intervenes, some sort of malady or manifestation that can only be fully described and attached a distinct label to using the underlying religious or medical teachings for the time.   We all are very much like Pavlovian dogs when certain kinds of changes take place within the body.  As unique organisms we alone usually set the stage for whatever events are going to ensue due to bodily changes, but it is the expectations set up by society and those people closest to us that dictate the route we are going to take once such a change is commenced.  This stimulus-reward scenario is brought about by expectations within our mind, and supported by behaviors of support from others.  This support takes one step further when the conclusion being drawn is justified by the claims generated by the experts of whatever topics these personal events relate to.  Doctors, physicians, society and medicine define what a disease often becomes, as people remain the victims of the sociocultural definition of what it is they are having.  The assumption being made here by the patient is that the physician or expert has to be right.  He may be right for the time, but as the years progress and public and professional attitudes and definitions for a medical condition change, so too does your medical state or “problem.”   Individuality usually does not dictate your future with a disease as you would like, people, professionals and culture define your long-term outcome in the end.  In this way, it is safe to say that many diseases are very much culturally-bound.  Their causes, manifestation and remedies are dictated by certain medical “Truths” or beliefs for the time, that’s “Truths” with a capital ‘T’.

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This is the basic premise for the development of the culturally-bound syndromes defined by medical anthropology writers (see http://www.visionandpsychosis.net/CBS_Article.htm, although this is way too simplified and lacks completeness).  Culturally-bound syndromes are those syndromes, medical states, behaviors or conditions that take place due to the cultural definition and expectations of a particular health related or physiological and psychological status.  In some ways, due to the long history and tradition of a condition that exists within a field, we are taught the expectations of the members of that field at large, and at times believe these expectations completely and so set the stage for further events to pursue supporting the ideology that particular profession or way of thinking has attached to the physical state and attached behaviors and other events being witnessed.  Culturally-bound syndromes are defined by the western medical world allowing experts in western medicine to openly express their points of view about diseases in a very ethnocentric fashion, a fashion that allows a disease to be defined in a specific cultural as accurately possible the most accepted cultural ideology.  There is no perfection in how western medical practitioners define and treat a culturally-bound syndrome.  In psychology, most definitions used the most widely accepted breakdowns of mental health disease for the time, whereas at time other cultural paradigms are allowed inclusion.  Thus there are many “mistakes”, definitions that are neither perfect nor absolutely right for defining the condition or “disease” state.

Diagnosis and prognosis are the two worst mistakes usually made in attempts to diagnose or explain a new situation, such as a patient demonstrating lack of control due to time of year, weather for the time, beliefs of the family, expectations of the doctors native to that culture.  Physicians (especially those outside the cultural realm) don’t know the true cause for culturally linked or bound diseases.  Yet we allow these outside experts to dictate the future prognosis and impacts of that disease upon each and every patient afflicted by it.  When people fall into the scenario being predicted, everyone is happy, sometimes even the patient with the condition.  But by taking that route, the patient has effectively made his or her own prognosis about himself/herself.  The future of the condition is now pretty much dictated and finalized.  Neither side is in any position of control any more on the long-term outcomes of the individual, just time and severity as it progresses define these outcomes.

This way of defining and prognosticating disease is the most important skill of the physician.  In the case of managing the physical course for disease, some prognoses are in fact predictable and accurate.  It is only when the physician begins to feel the same can be accomplished for mind, mental, emotional and/or cognitive (thought-based) diseases that problems begin to erupt in how the physicians at the time take the culturally-bound avenue to define a patients mental state and mind-body diseases state.  These doctors, at some point of time in medical history, are suffering from their own delusional states if and when they think their Philosophy is 100 percent correct.  Thos most aggressive about doing this have some sort of superego control problem.  Those engaged but uncertain about how to progress along this professional path may have some past incest related problem or desire for a relationship with their mother getting in the way.   But oh yeah, that was how Sigmund Freud might have interpreted things, and his philosophy was totally thrown out by these professional who could not bear to hear that they too could have some sort of uncontrollable onanist disorder due to a past maternal relationship.

The mental health patient is the worst victim when it comes to culturally-bound limitations posed on regular medicine.  Since the human affect plays a very important role in how we diagnose individuals, we have to always reconstruct our diagnoses to better fit the  attitude for the time regarding mental health and psychological or psychiatric therapy.   Psychiatry is a field of medicine that it as out of touch and in a state of both atrophy or hypertrophy at the same time, that there is little for onlookers to do except maintain control as much as possible with their own mental state.  The followers of medicine do not own your mind as much as they have the rights to own and control your body using prescription medications.    During the very late 1700s and very early 1800s, this was not the main problem with this part of the medical profession.  During that period in American medical history, it was a matter of determining what human behavior was and what the mind was in relation to the brain.  During this period in time, Descartianism dictated what doctors could do since they were finally learning how to chemically adjust the body from that with a distinct soul and corpse, to one in which the soul could be ignored and the influences of the spirit quelled through the use of medications.  Each patient was now another potential experimental setting in which the next study of drugs, therapeutics, and psychotherapeutics could be tested.

In the following illustration from a late 19th century book published out of upstate New York, several women were photographed by the author, who was trying to make a point on how human behavior and affect change due to the surrounding environment.   This photograph was taken in the Rochester area.  A description or identification of the “patients” engaged in this psychological test by the author was not given.

The author of this experiment claims that by making a simple change in the environment immediately surrounding these three women, that a major change in their affect and behavior can result from such a change.

The point the author was trying to make here is that we are often victims of our environment.  At the time, the emphasis of this environment referred to the physical environment more than the social or sociocultural environment.  The sociocultural influences are what I have added to this scenario, for it is these stimuli that define what is seen, why it is seen, and how it is documented and interpreted.  The first picture above in this pair displayed women who were relating to the North Pole of a magnet, the second picture was the same in relation to the south pole.  Now granted, these pictures look pretty much staged, especially when you take into consideration what the author claims is the cause for these major changes in affect–magnetic fields and how they influence our mind.

Still, although melodramatic, the author made his point to the reader with these pictures.  Credible or not, he is trying to claim that there are opposing influences at play within the environment in relation to human behavior.  One is the expectations we have about ourselves and the environment based on practical experience.  The second is the “power of suggestion.”

We can deviate from this scientific and largely philosophical attempt to prove a point, and turn to the fact that there is a more controversial social darwinian way of looking at all of this.   If we imagine social networking and interactions between people as playing a key role in human behavior and affect, then reward-punishment model for all of this takes on more meaning.  The above women’s behavior will continue if the ideology and related behaviors continue to be promoted and are believed in.  With time, more followers and soon you have a popular culture movement.  In just a short time, the impact of this socially and culturally defined belief system and phenomenon resulted in a strong belief system and social movement aimed toward promoting this belief system further, quite often of course due to underlying economic goals, but sometimes just belief in the philosophy or the desire for fame.

A similar attitude and belief system were propagated in this same vicinity about 50 years earlier.   In 1845, three young girls initiated a social phenomenon that had been around for quite some time, but now for the first time was able to develop a major following.  People were now gullible to this type of socially fed belief system, and so were attracted in masses with the goal of witnessing and learning more about these special “spiritual” events.  These three sisters were the Fox Sisters or spirit rappers of Rochester, NY.

The Fox sisters benefitted from the fact that this ideology was not necessarily new to the region.  Many families grew up learning about local haunts, visiting spirits, the neighbor’s deceased grandmother displaying herself in the household as some sort of vapor cloud that came to be known as ectoplasm.  In the Hudson Valley, New York region, this belief system was carried here by many British and Dutch travellers settling down in the region, along with some uniquely thinking German and Jewish families.  The alchemy of life, the ens of Paracelsus and Hermann Boerhaave, the vital force of Borden and later reinventors of this philosophy, all had an influence upon the social beliefs and psychology for the time.  During the late 1790s, when Captain Stephen Thorn’s daughter had her interactions with a ghost spirit in their home down by Fishkill, this caused spoons to fly and objects to be raised upward against the force of gravity.  Today when we drive by a swamp we feel the humidity and see the mist rising from the water.  During the yesteryears this same effluvium was seen to be the cause for disease, or even earlier, the spirit of Catherine watching over her land on horseback.  Even Edgar Allen Poe and Washington Irving couldn’t avoid digging into the basis for these historically important tales too much, as much as I am doing now.  In a way it is the humor (humours) that really drag someone into this line of thinking, one might say.  Whenever you suspect that people are making things up, you have to look, ponder and teach these stories, or in this case also write about them, at least for myself and two others.

Where else does the New Yorker’s innovation combined with the gift of imagination take us.  There is this one other example of  a story that will be mentioned before returning to the Divine nature of these “psychiatric Truths” (capital ‘T’ intentional)–that of Andrew Jackson Davis.  Andrew Jackson Davis, whose name is now nearly forgotten by local historians, was the rage of the United States, and later, even more so in Great Britain.  Like many traditions of the occult and “magick”, once the British took on the writings and philosophy of Davis they treated him much like the Swedenborg for the period.  They couldn’t find enough of his writings on mysticism and metaphysics to satisfy the rapidly growing population of psychomancies dying for further insight into such arts or sciences as telepathy, seancing, etc.   Davis began his personal worship of this unique trade sometime close to 1840, after seeing a presentation on hypnotism presented by Phineas Quimby, the creater of the orb or orrt  cloud philosophy, who was making his way through Poughkeepsie during his national promotion of his unique skills.  Like most seers and the like, the people were convinced and involved more than the skeptical trademen like physicians, scientists and many religious leaders.  Yet the occult nature of Quimby’s and later Davis’s preachings was enough to establish a pretty decent following, and a reliable source of income.  In the following illustrating telling a couple of events in this story, we see Davis meeting Swedenborg and Pliny for the first time, an event which first took place in his personal life within a set of clouds positioned above the Mount Beacon skyline.  In the third drawing, to his left, he is seancing with the spirits in the sky from a three story home in the Lyme area of Massachusetts.

Currently, medicine likes to link culturally-bound syndromes to particular ethnic and cultural groups.  This highly biased way of defining culturally bound syndromes is an attempt of the profession defining these conditions–the regular medical field–to put these diseases into its own perspective of things, as if only its perspective is correct, and its ideology and philosophy are the only method of diagnoses that is absolutely true–the best there is–and as if this current perspective in place is the final ultimatum in conditions of the body and mind, the only series of philosophies for disease that are the most correct, if not totally correct.  Over the last century or two medicine has tried to define this particular lack of success doctors have with handling all diseases in several ways.  The easiest way to go is to simply say the medical condition is made up and totally constructed by the mind and ways of human thinking and the corresponding behaviors following by corresponding biological and physiological events that ensue.  During the 1940s and 1950s this became known as psychosomaticism, the ability of the body or soma to manifest a disease or condition in need of treatment due to some sort of psychological state one is in.

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Psychosomatic medicine in its earliest and purest form marks a fairly narrow period in medicine, when physiological was just about to become a molecular form of study for the first time, as the chemistry of the human genes and chromosomes came to be understood for the first time during the early 1960s.  Until this time, the knowledge we had of the body as a scientific object in need of intense study researched all of the basics of life and physiology, focusing on chemical and structural features like neurotransmitters, the influences of specific drugs (hallucinogens, opiates and pain), the effects of human and animal manufactured substances known as hormones on the body.  Along with this intense focus on chemistry there were also the studies of how these chemicals interacted with the body and why.  Such studies included the discovery and intense review of plants on some cell or tissue documented to interact with those chemicals, thereby resulting in the physical, followed by emotional and even thought-related changes that a person in turn goes through due to the intake of that chemical.

By the end of the 1960s, scientists and physicians felt they understood everything they needed to know about genetics, cell physiology, biochemistry, and disease.  All of the understanding of the human body and the behaviors people engage in as these relate to health, had some sort of body-mind or body-brain association with how these events ensued.  This form of medicine in itself is a culturally-bound philosophy being generated from how we construct our reality based on science and scientific observations.  It is distinctly different from how the shaman in Brazil defines the interactions or people and animals with their surrounding physical substances, like plant drugs, and is very different from how the local herbalist next door in the modern age believes in and uses his/her unique form of herbal-based aromatherapy, homeopathy, or bach flower remedies.  In medicine, even the most modern form of medicine, it is a philosophy that dictates what will be used to treat an individual for a particular malady defined in a particular way.

In all of these scenarios, the outcomes that are produced from these treatments are as truthful as they can be, not necessarily the perfect and most correct form of therapy, but the most truthful in the mind of the practitioners.  It is the intelligence or lack thereof of the practitioner that limits this form of therapy to such an extent that is becomes a failure instead of a success.  When it is a failure, we again turn to own cultural upbringing to define whether such an outcome was right or wrong–did the physician treat his/her patient in the best way(s) possible given the circumstances and knowledge base for the time?

So, what other disease types manifest themselves according to cultural beliefs and traditions?

It is possible that some manifestations are developed as learned behaviors.  Even without the conscious mind and thought process sending along your way down that particular culturally defined route you need to take due to disease, you take it as a result of the subconscious unconsciously going through neurologically preprogrammed emotional and sensorimotor activities resulting from learning experiences.  The “disease” (your thoughts about it and your reactions to it)  learns to manifest itself it particular ways, based upon expectations.  The sociocultural impression upon a disease is manifested when there is a strong cultural presence in the expected behavioral outcomes of the particular manifestation at stake., needed for the diagnosis to once again be confirmed, and the sociocultural reasoning behind that expected theoretical outcome also confirmed.  Back around 1800, when you manifested your condition and it met the needs for a particular paradigm then being practiced, you, your family, your physician, all behave in the treatment method according to tradition, even if that tradition is some “new age” diagnostic and treatment plan developed for this very unique culturally defined medical problem.

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This takes us back to Dr. Samuel Mitchell’s discovery of a new diagnosis for an incredibly unique disease, perhaps the first of its kind for all time–Divine Somnambulism.  The following article appeared in the Poughkeepsie Journal on December 28, 1814.

Like his work on the phlogiston theory of disease, in which Mitchell tried to explain come diseases based upon an undiscovered chemical element in nature.  His argument stated that this element helped to cause the effluvium being ejected in well localized regions where certain diseases persisted, in spite of no known or identifiable cause.  Dr. Mitchell was about to produce his own theory of Rachel Baker’s condition.  He was going to avoid defining it as a purely psychological condition, such as a lack of control of the animal spirit, a tendency to display too much of the passions in you, or the tendency for specific diseases to manifest themselves both internally and externally.

Medical doctors in 1800 performed the most accurate form of medicine for the time, for the most part.  There were those whose philosophy travelled along a different path at times, even switching over to the religious pathway often, but if for the moment we allow both religious philosophy and medical philosophy to be true for the time, then everything being practiced to effect the cure was correct.  The laying on of hands for treating one person was and could be just as effective as a regular physician bloodletting the individual who believes in bloodletting, or the religiously minded physician whose philosophy relies completely on nature’s gifts and blessings involving the body, meaning that no intervention is allowed other than those with natural and biological purpose.

Notice now how our attempt to understand the philosophy of medical treatment tends to remain locked to traits related to the physical world.  There is little to no involvement of human psychology and human spirituality in any of the above description of therapeutic endeavors so far.  But since psychology and thought are closely linked to the body, how we perceive its physical state, and how it performs with regard to health and disease, we find that it does not help to exclude the psyche from the medical world.  The study of human thought and psychology at this point in time were evolving.  So it was becoming more and more necessary for doctors as well as religious leaders to come to a better understanding of the body and mind before venturing too far in their distinctly different lines of reasoning with regard to disease and behavior.

Around 1800, medicine pulled religion into its philosophical world once again, not as a tradition to beginning to adhere to and follow its teachings word-for-word once again, but rather as something to study as a manifestation of the mind and people’s behaviors, and people’s physical states and disease states.

Another fascination at the time in Poughkeepsie was a young girl touring through the region.  She possessed this unique “power” as many people would refer to it today, but that then it was only described as some sort of variation on the disease notion.  It wasn’t really a disease in the traditional sense, being a physical manifestation principally of the body and such, but rather it was a manifestation of the persons spirit and mind, and perhaps even that which was felt to exist very close to the soul.  Her ailment, if we can call it that, was Divine Somnambulism.  Her condition manifested itself in the form of a gift of prayer.

This story reminds me of the time when Jasper Danckaerts, the legendary explorer and travel writer of Labadian background, who made his way up the Hudson River Valley in 1667.  Before he engaged in this venture, while in the Netherlands, he was searching for Elizabeth Filipse, the first wife of the future claimant and owner of the entire county of Westchester that he and his wife populated around 1650.   Trained in several languages, she was essentially the businessman in the Filipse capital venture of settling and developing this portion of the New World.  When Danckaerts walked by an assistant to Elizabeth, who was just standing there out in some open area just a few feet or yards away from the outdoor revival tent Elizabeth had raised for her and her 100 or so cult-like followers, Danckaerts noted how this assistant spoke as though he could tell what she was doing for the time, seeing her misty spirit in his very imaginative mind, knowing what activities she was engaged in at the moment.  Being the heart of the Boehmite period, when Jakob Bohme the mystic was very popular in Dutch Reformed history in the Netherlands, this sort of behavior was typical.  Were this to take place today in Haarlem or Amsterdam, or even per se the hamlets in New York City with similar sounding names, such an individual might be “diagnosed” differently, based on sociocultural attitudes.

In Salem, Massachusetts there is the famous history of the Witchcraft that Puritans were opposed to.  Whereas one Puritan leader denounced such behaviors in the 1690s, a terrible societal reaction to a behavior they misunderstood the description for which was  matched and opposed by Cotton Mather as a consequence of Datura intoxication, by 1715-1720 even citizens of the Hudson valley still could not fully understand certain female behaviors and attitudes, and so brought one their own local heiresses to court for possible witchcraft behavior.   With this history of the potential for mistreatment of the colonial dame, we hear very little about their professional behaviors other than as a maiden, spouse or mistress.

The ability of someone to “channel” or connect with another through metaphysical space is very much a popular phenomenon in local Hudson valley history, and would recur more times in local tales and stories over the years than could ever be imagined.  We just didn’t have the complexity of mind to imagine and realize all of these strange beliefs and forms would form in the Hudson Valley.  No one could have, “in their right mind”, predicted the future existence of the Divine somnambulist.

The study of psychology was in its infancy around 1800.  The coining of the term “psychology” is seen in an early book entitled “Psychologie” dated about 1800.

The study of human psychology began when psychology wasn’t even yet truly defined.  This particular field of medicine now considered a specialty of certain allied health branches of the medical curriculum had a very informal and almost completely missed start, were it not for the few individuals whose behaviors constantly reminded us that such a study and even practice related to medicine and/or spiritual counseling had to exist for some people.  These individuals were desperately in need of something that plain doctors could not provide, and church leaders were at times hesitant to engage much in.

In some ways, this “Divine” gift or skill was something straight out the Bible.  One could also liken it to a speaking of tongues in some way, or to the ability of someone like Emanuel Swedenborg to converse with angels.  Just what she was doing during her “Divine Trances”  (my term) is uncertain.  Was she fully conscious of who and what she was being?  Was she aware of what others saw when they were in her “Divine presence”?

Her story sometimes reads like the tale of someone in a trance, or more importantly, someone who was somnambulant, a sleep-walker.

The modern impression of the somnambulant state of consciousness is that the mind and brain are working, but not necessarily completely in unison with each other.   We have this cultural biasness to how we imagine sleep walking to be and the types of events it is supposed to consist of, how people are supposed to appear when they are engaged in this activity.   This is like the culturally defined expectation of falling to the ground when the snake of evil is within you, in need of exorcism, whilst others look on in the evangelical faith healing church setting.  By engaging ourselves in the healing act in a way that is expected of others, we get the social support we are searching for, which in turn strengthens this healing process and puts everyone, especially the healer on the right path.  Being in cultural context is important.  One doesn’t go to the doctor’s office, undergo some physical exam, receive a prescription and couple of words of supports, and then fall to the ground, only to stand up again a minute or two later with the nurse laying on hands and the doctors and medical staff saying your condition is now completely resolved.  This series of events is culturally out of context.

There may be consciousness, meaningfulness and reasoning behind what we are doing when we are awake, but this is not totally there when we are engaging in the same during a period of sleep.   We perform some of our somnambulant events as if these activities were being performed in some fully conscious state, engaged in physical events that are so habitual that they were programmed into the brain.  But they do involve a certain sense of knowledge, awareness and even cunningness at times, to such an extent that certain events engaged in during this state of being could be construed as actions taking place with full consciouness and intent involved.   With somnambulism, it is infrequent if nor unusual, if not even rare, for true and complete consciousness to be in charge of what we or our body does during a  sleep walk.  But there is some sense to that activity, and the actions taken.  It is not the reflexes of motor activity involving cerebellar activity, or the product of a completely awakened midbrain derived alert and conscious decision process.  The reason for this activity is taking place somewhere in that “twilight zone” of the brain, that place that we still have yet to find and fully understand, that part of the brain that requires only the dissection of animals or the morbid remains of a human brain to be able to draw a map of this part of the structure, hoping to make good “sense” of it, a “sense” that we really never will get to know.

Madamoiselle Divine Somnambulist has a long story attached to her psychology and natural philosophy.  Most importantly, her presence as this gifted and somewhat disabled person gave the medical profession and physicians a very unusual doorway into being able to openly discuss God, the spirit and the body, without looking as though they were reverting back to their church-born ways, away from the natural theological practices.  Leading this spiritual journey for the profession was none other than Samuel Mitchell, the New York medical doctor and naturalist who liked to link every one of the natural studies to medicine in some way shape or form, as if medicine was really just a study of the consequences of our exposure to these things of nature.  But Dr. Mitchell did have his quirks, so to speak; he was getting old enough to be like Samuel Bard and others, who in their later retirement years walked away from the medical book and back to their religious books.  Dr. Mitchell wasn’t as tied to the church as Bard was, but he was open to the talk about God and the Universe.  This kind of talk was the opportunity that Mrs. Divine gave to Mitchell.