Mind Hacks

The term “involuntary” used to describe Tourette syndrome tics is a source of confusion since it is known that most people with TS do have some control over the symptoms. Before tic onset, individuals with TS experience what is called a “premonitory urge,” similar to the feeling that precedes yawning.

What is recognized is that the control which can be exerted from seconds to hours at a time may merely postpone and exacerbate outbursts of symptoms. Tics are experienced as irresistible as a yawn and must eventually be expressed. People with TS often seek a secluded spot to release their symptoms after delaying them in school or at work.

Typically, tics increase as a result of tension or stress (but are not solely caused by stress) and decrease with relaxation or concentration on an absorbing task. In fact, neurologist and writer Oliver Sacks has described a man with severe TS who is both a pilot and a surgeon.

Fascinating section from the Wikipedia article on Tourette syndrome.

Link to Tourette Syndrome Association (UK).

A psychoanalyst once proposed that ‘madness is when you can’t find anyone who can stand you’. This is not such a flippant definition as it might first appear. In practice, the mad are created when those around them can no longer cope with them, and turn them over to specialists and professionals. They are people who have broken the ties that bind the rest of us in our social contract, who have reached a point where they can no longer connect.

But by this definition James Tilly Matthews, paranoid schizophrenic or not, was not mad. It is striking that throughout his story, even at the prodigious heights of his delusions, there are always those around who trust him, and he consistently inspires sympathy, affection and love.

From Mike Jay’s The Air Loom Gang: The Strange and True Story of James Tilly Matthews and his Visionary Madness (ISBN 0593049977, p58).

Matthews had previously been involved in peace negotions between France and England and returned believing himself controlled by a mysterious ‘air loom’. Also believing the government to be under its influence he shouted “treason!” in the House of Commons.

After his arrest and confinement at ‘Bedlam’ Hospital, he became the subject of the first ever book-length psychiatric case study in 1810. John Haslam, the hospital apothecary, wrote-up his case as part of an effort to embarass the medical establishment who he believed, contrary to their claims, did not understand either madness or Matthews’ case.

Link to article on James Tilly Matthews and the ‘air loom’ by Mike Jay.
Link to John Haslam’s 1810 ‘Illustrations of Madness’.

Wikipedia has a fascinating article on the phenomenon of hikikomori – where large numbers of Japanese adolescents are socially withdrawing, often to the extent of seeking extreme isolation and self-confinement, presumably due to various personal and social difficulties.

Although the article hints that hikikomori is considered a phenomenon of medical concern, there’s very little written about it in the medical literature catalogued on PubMed.

This may suggest that the (largely Western) medical literature has not touched on the subject, or that the phenomenon is not usually considered of psychiatric importance, even in Japan.

There’s plenty of links to news sources discussing the phenomena on the Wikipedia page, but I’ve not been able to find many substantial english language articles written for scientific or academic publications.

Any pointers greatfully received…

Link to Wikipedia article on ‘Hikikomori’.

A stranger has come
To share my room in the house not right in the head,
A girl mad as birds

Bolting the night of the door with her arm her plume.
Strait in the mazed bed
She deludes the heaven-proof house with entering clouds

Yet she deludes with walking the nightmarish room,
At large as the dead,
Or rides the imagined oceans of the male wards.

She has come possessed
Who admits the delusive light through the bouncing wall,
Possessed by the skies

She sleeps in the narrow trough yet she walks the dust
Yet raves at her will
On the madhouse boards worn thin by my walking tears.

And taken by light in her arms at long and dear last
I may without fail
Suffer the first vision that set fire to the stars.

‘Love in the asylum’ by poet Dylan Thomas (1914 – 1953).