Saturday, July 19, 2014

More on Memory

After posting the last installment on this blog, a blog I did not expect to maintain after returning from Australia in 2011, I continued, and continue, to think about memory.  Due to a sequence of events and readings I came across Paul McHugh's book, Try to Remember: Psychiatry's Clash Over Meaning, Memory and Mind.  This is the first time in a long time I found myself lying in bed, reading, and trying to hold my eyes open manually for a just a few more pages.  Fascinating book.  After three days I'm halfway through (I've got several books going at one time including two in French).  McHugh is the retired chief of psychiatry at Johns Hopkins and a very significant player in the world of psychiatry.  Superb writing. 

The first half of the book deals with one of the most shameful and embarrassing episodes in the history of psychiatry: "recovered memories," "multiple personality disorder," and  "ritual satanic abuse," (this last is my all-time favorite) weirdness that was peaking when I began psychiatric residency in 1989.  Though I could not articulate why at the time the whole movement struck me as bizarre and wrong.  It was, and is, wrong and wrong-headed.  It would be difficult to estimate the amount of suffering endured by innocent  men, women and families who were wrongly and, to use a word that is out of fashion in American society, sinfully accused of heinous acts that never happened. 

I remember being aghast that there were two "multiple personality disorder units" in Philadelphia when I was a resident even though I didn't have the vocabulary to explain why.  Two.  Both were at prestigious institutions though I can't recall which two.  A lecture to our class by one of the "leaders", alas a psychiatrist, only strengthened my cynicism.  WHAT KIND OF MAN shows up to give a lecture to psychiatry residents wearing a black leather blazer??????  The only thing missing was a riding crop.  We had a field day mocking him in the residents' room after the lecture. 

I had the unhappy opportunity to deal with a "survivor of ritual satanic abuse" at one point in my career, fortunately not in a treatment relationship.  She was psychotic at times and horribly over medicated. Her descriptions of the rituals that the satan worshippers used would have been laughable had they not been so sad.

McHugh is eloquent in his writing against the memories that were implanted in the minds of vulnerable women (90% of patients were women).  Even when they denied that anything happened, insistent questioning and an interrogation and conversation manner generally reserved to Edward G. Robinson movies, eventually wore away many patients' resistance. Then the damaging false accusations flowed.   McHugh's description of the "therapists" who conducted the work, the vast majority of them non-physicians, was succinct.  Incompetent.  Unfortunately many judges were gullible and meted out long sentences to the falsely accused.

One of the fascinating factors in memory is the role of the limbic system (George Murray's favorite part of the nervous system), a primitive part of the brain that attaches emotional valence to experience.  The evolution of the limbic system can be traced back to amphibians.  It is an early warning system that does not operate in shades of gray.  Rather it is black or white.  No subtlety.  Dangerous v. Safe.  Over the years research has shown that the limbic system appears to be more efficient at attaching valence to negative, dangerous and harmful memories than to happy pleasant ones.  The survival value of such a system is obvious.  If a seven year-old places his hand on a hot stove burner the limbic system will encode that experience so that it doesn't happen again.  And I didn't.  Indeed, whenever I was in my mom's kitchen until her death 53 years later I checked the burner very carefully and gingerly rather than placing the entire flat of my hand against the burner as I did then.  The whole scene would replay in my memory including the fact that mom watched me do it.  She couldn't stop it because I acted so fast; she could only react after the fact. 

A number of years ago I had to work with a patient who was being "treated" by a non-physician "therapist" for "multiple personality disorder."  It was an unusual case in that the patient was a man.  He did not have MPD but rather a not rare form of non-convulsive seizure disorder.  The "MPD" responded beautifully to anti-seizure medication and having him end "therapy" that was suggesting symptoms to keep the MPD train moving.  Unfortunately I have no follow-up beyond six months.

The Broadway musical, "The Happy Time" opened on Broadway in early 1968.  It ran for fewer than 300 performances and has the distinction of being the first Broadway musical to lose $1 million.  I saw it (and very much enjoyed it) with my oldest sister in the summer of '68 a few months before it closed.  The entire story takes place in the memory of a sybarite photographer from a French Canadian village.  Several of the songs are meditations on memory. I've listened to the soundtrack several times this week while putting down thoughts on memory for the conference in Florida. As the opening line of the first song points out "The memory plays tricks."  Weirdly enough, in the context of what I've been writing, that trip to New York with my sister created a hilarious memory that only she and I can share.  No one else finds it even remotely funny.

Despite having discounted the whole silliness of recovered memories, a silliness that Paul McHugh helped stop, it is embarrassing to think that I am a member of the profession that helped create it.  Alas, the DSM continues to use terms such as dissociative identity disorder that fail to correct wrong-headed assumptions that are completely unscientific.  Ah yes, recovered memories.  I prefer the term false memories.  It is more accurate. 

The memory plays tricks.  Incompetent or unscrupulous therapists play even more tricks. 

The French do not call 14 July Bastille Day.  Some of them are a bit touchy about that.  Referring to the French National Holiday as Bastille Day marks one as a tourist or woefully uninformed.  The day dawned ugly as had the previous nine days.  (See the whining in the previous entry on 14 July.)  Somewhere around 2 or 3 PM I looked out the window to see splendor.  Sun.  Blue sky.  No clouds.  No humidity.  Gentle breeze.  YESSSSSSSS!!!!!!! (with frantic fist pump action).

Went out with the camera at about 8 PM.  Fireworks scheduled for 10:30 PM.  I wandered to Bellecour and then across the bridge toward the school, crossing over the Rhone.  Talk about a 'lead us not into temptation' moment.  Crossing the bridge I encountered the first of the food trucks.  Among the offerings was French fries.  Frites.  Chips.  HEAVEN.  It would have been possible to purchase 1 kg (that is 2.2 pounds folks) for 7 euros, about $10 or $11.  I was kept from indulging not by the four not-there-until-2011coronary blood vessels but by the possibility of getting grease on the camera. 'Tis the greatest treason to do the right thing for the wrong reason.'  Guess it is. 

Because the fireworks were to be shot off on the grounds of the Basilica at Fourviere I went back to the house for the tripod and cable release.  Found a place at the corner, perhaps 200 yards from my room, where I could tuck into a recess in a building, lean against the wall and keep the legs of the tripod out of the way of pedestrian traffic.  I made one boneheaded beginner's error that may have diminished the quality of some of the firework (feu d'artifice) photos but all in all I am pleased.  The viewing area along the banks of the Saone was packed.  I suspect Bellecour was a zoo. What a pleasure having to walk only 200 yards home.  It was going to be ugly on the roads and on public transportation.  (Parking in our part of Lyon makes Boston look good). 

The first photos feature the Basilique ND de Fourviere before the fireworks. 

Just after leaving the house at about 8 PM.  It does not get dark in Lyon until very late in the summer.  Thus this is the only time I've done any nighttime photography. 

I then went to Bellecour, a huge public space where I catch the subway daily.  It is surprisingly devoid of trees in the center.  That fact does, however, allow it to be used as a public performance space in ways that would not be possible otherwise. 

There was a guy there making huge bubbles using two thin poles and rope about the size of clothesline (for those of you who remember what a clothesline was).  Little kids were going berserk chasing the bubbles.  I could not take as many shots as I wanted to because of the girls' shrieking.  The sound hurt.  Yes it was possible to take pleasure in their sheer joy but the shrieking still hurt.  Got similar photos in Sydney on 30 July 2011.  However, that was around noon.  Got much better prismatic effects this time.  

This cafe is just a few steps away from Bellecour.  

This was taken about 9:15 on the way back from the direction of the school through Bellecour again and heading to the house.  I will admit to enhancing the silhouette aspect.  Love to post-process shots like these. 

Just before the fireworks with tripod and long exposure.  This was a test.

And now the fireworks.  They are not easy to photograph.  A tripod and cable release are requirements.  A fast lens helps.  That is the difference from 4 July last year when I was taking photos from a friends balcony in Marblehead.  This was a faster lens.  Overall better results. 

+Fr. Jack, SJ, MD

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