Gravity's Rainbow

botany, shoes, books, and justice

July 9, 2016
by sarcozona
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He worried that so many migrainous women sought diagnostic tests and spent so much money on doctors when doctors had so few effective migraine treatments. The more appropriate role for the physician, he argued, would be to spend time with the patient, “in talking over her life problems and in showing her how to live more calmly and happily, than in making useless examinations.” “It is an axiom with me, he added, “that whenever a woman is having three attacks of migraine a week, it means that she is either psychopathic or else she is overworking or worrying or fretting, or otherwise using her brain wrongly.

Joanna Kempner in Not Tonight

Yes, 8 year old me must have been reading too many Redwall novels. And programming is definitely too much for my poor lady brain.

Also everyone, their mother, and my GP want me to go to therapy regularly. Therapy that is $100-200/session when only $300/yr is covered.

July 8, 2016
by sarcozona
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…Wolff’s discussions of women and migraine were intriguingly limited, especially given that by then most physicians had agreed that women experienced migraines more often than men. Much like his Victorian predecessors, Wolff preferred to talk about headache disorders in the masculine. Likewise, his descriptions of migraine emphasized masculine anxieties about the rigors of work life.

Joanna Kempner in Not Tonight

The “father of headache medicine” basically ignored ¾ of patients.

July 7, 2016
by sarcozona
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If, as Foucault argued, modernity was the act of disciplining bodies, then Wolff’s migraine personality was discipline in its extreme—a pathological reaction to the corporeal demands of power. His subjects’ neatness and fastidiousness, he wrote, was exceeded only by their efficiency. People with migraine loved order and repetition, feared failure, and resented interruptions. They created elaborate “schemes, plans, and arrangements,” but “had great difficulty in complying with or adapting themselves to systems imposed on them by others.” The description of type A personalities varied depending on who had them. Women migraine patients who “worked” at home also wanted everything to be “just so,” but they had difficulty delegating even simple household tasks, like dishwashing, to housemaids.

Joanna Kempner in Not Tonight

This is how a 9 year old whose head won’t stop hurting gets sent to clinical progressive relaxation training

July 6, 2016
by sarcozona
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Wolff’s migraine personality was also informed by a burgeoning psychodynamic literature that viewed bodies as “systems of psychobiological adaptations.” Using this framework, migraine could be understood to be a protective device that provided a way for the body to withdraw from stressful situations. In fact, migraine was thought to be an especially useful adaptation for overruling an overdetermined, overly ambitious mind. Nevertheless, this psychosomatic framework emphasized the realness of migraine. Should any of his students forget that emotions could have as real of an impact as any somatic, measurable fluid, Wolff would remind them. Scrawled on the bottom of his lecture notes were the words “You are at the beginning of a new era when—Loves Hates Fears are as real as management of lump [sic] in the chest or pus in the pericardium.” Psychosomatic medicine did not, for Wolff, mean “imagined.”

Joanna Kempner in Not Tonight

Whereas psychosomatic now means the doctor is washing their hands of you.

Also HAH we distinguish between mental and physical states.

July 5, 2016
by sarcozona
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Clavus hystericus, sometimes called “hysterical headache,” is the clearest example of a gendered diagnostic category in this time period. In his Treatises on the Diseases of the Nervous System, James Ross describes hysterical headache as a variation of hysteria: “Hysterical Headache is met with in females, and is generally accompanied by other symptoms of hysteria. This form of headache is on the one hand closely allied to trigeminal neuralgia, and on the other to true migraine. The pain is sometimes diffused and deep-seated, but it is more frequently limited to one spot, and feels as if a nail were being driven through the skull; hence it is called ‘clavus.’ Hysterical headache is increased in severity during the menstrual period and by mental worry, whilst it is removed by amusement and anything which engages the attention.” “Hysterical tendencies” could distinguish the pain of clavus hystericus from other headache disorders, although authors were usually vague about what, exactly, constituted these symptoms. In his 1888 monograph on headache disorders, Allan Mclane Hamilton suggests only one objective distinction: “Hysterical women are very apt to complain of very great diffused hyperaesthesia of the scalp, so that the simple act of brushing the hair causes great distress.” (This complaint might now be diagnosed as allodynia, which is a pain condition associated with migraine.) Knowing which of his patients had what Hamilton called “neuralgia,” which is described in his book as having a solid biological basis, and which were merely hysterical was important for treatment, as hysterics “are more apt than any others to form the opium habit, or that of alcoholism, and great care should be taken lest, by yielding to their demands, we foster something worse than the headache or hysteria.”

Joanna Kempner in Not Tonight

Today’s discussions of the opioid epidemic and chronic pain, whose pain is real, and who deserves treatment echoes some very old discussions.

July 4, 2016
by sarcozona
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John Symonds’s 1848 lecture about the relationship between migraine and nervous temperament shared these gender and class assumptions. But he added a new dimension: “Such persons may also feel pains which have taken their origin from mere ideas.” And, thus, Symonds became the first—but certainly not the last—headache doctor to suggest in print that head pain might be caused entirely by suggestion. Or to phrase his contribution more accurately, suggestion could only bring on disease in a person whose body had already been weakened by “nervous temperament.”

Joanna Kempner in Not Tonight

Migraine is your fault, or fuck John Symonds and all the doctors who believed him.

July 3, 2016
by sarcozona
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Cheyne did not, however, see weak nerves as entirely unhealthy. The thinner and more fragile the nerve, the more quickly it could transmit a quality called “sense.” “Sensibility” conveyed aesthetic, intellectual, and social refinement, made one a “quick Thinker,” and provided the “most lively imagination.” Talented people were born with “organs finer, quicker, more agile, and sensible, and perhaps more numerous than others.” In contrast, “brute Animals have few or none, at least none that belong to Reflection; Vegetables certainly none at all.” Sensibility could be cultivated, but was also seen to be biologically rooted and inborn, determined directly by the exquisiteness and delicacy of one’s nerves. It was simply an unfortunate irony that refinement of nerves coupled so tightly with susceptibility to illness. People of good breeding, high sensibility, and excellent moral character were expected to come down with nervous disorders, like hysteria, hypochondria, or the “Vapours.”

Cheyne’s description of the nervous system and its disorders mirrored the clearly demarcated race and class boundaries of the time: the upper class with their weak nerves and sharp senses were biologically built for sedentary and intellectual professions, whereas the working class’s (and African’s) robust nerves and dull senses had the perfect build and aptitude for physical labor. But this logic presented a puzzle when it came to women, as they suffered from hysteria and other nervous disorders with greater frequency than men, but were not considered intellectually superior beings.

Joanna Kempner in Not Tonight