The mad, the bad and the sad. Your number’s up.

Suzanne O’Sullivan (2015) It’s All in Your Head. True Stories of Imaginary Illness.

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I like stories of imaginary illnesses. Dr Faraday in Sarah Waters The Little Stranger errs on the side of caution and attributes a collective form of psychosomatic illness to the aristocratic Ayre’s family staying at rundown Hundreds Hall, and the subconscious as place and time combine, the equivalent of old cartographers whom declared this be the end of the world, here be ghosts. The coroner at Caroline’s death was quite happy to accept that she died while her mind was unbalanced. I thought it was her body that toppled over the balcony, but there you go, it was her mind. The two are inextricably linked.

Wilkie Collins in The Woman in White has private asylums, doppelgangers and rich hypochondriac uncles that can’t bear loud noise, or indeed most everyday noise, as key parts of his plot.

Suzanne O’Sullivan touches on The Devils of Louden and it’s clear that she doesn’t think there was anything devilish about them. O’Sullivan calls for a compassionate response to those suffering from illness, whether mental or physical, because one impinges on the other. Fling in Abigail Williams from The Crucible. It takes more than one to cry witch, to be heard and collective responsibility must be taken seriously. One of my favourite stories wasn’t directly about the sad, the mad or the bad, but the gullibility of the rich for new fads.

I’m biased in that way. Those that could afford a nurse and private asylum in Collins’s time would be treated far better than those in Bethlem Royal Hospital that coined the term Bedlam.  Just before the start of the First World War a young Winston Churchill was calling for the creation of purpose-built asylums where feeble-minded men and women could be segregated from the general population. Sterilisation of women would be compulsory to ensure they did not reproduce. These measures were introduced in some American states. Eugenics is a rallying call against the poor. I like to listen to rallying calls against the rich. If you want to look at how the poor were treated during the First World War for shell shock Pat Barker’s Regeneration novels shows the dichotomy of how anthropologist, ethnologist, neurologist and psychiatrist W.H.R. Rivers treated officers of the ruling class at Lockhart hospital, most notably Siegfried Sassoon and Robert Graves, and how Rivers’s counterparts tortured working-class soldiers until they were reported fit for duty. Post-traumatic-stress disorder treated with electric shocks to make the blind see and the lame walk is nothing new. If you’ve got an imaginary friend you better get on the blower to him quick style.

Julian Barnes short story ‘Harmony’ tells the story of a young musical prodigy Maria, born 15th May 175-. The child’s health was normal, until she woke up blind at the age of three and half. It was held to be the perfect case of amaurosis, there was no fault detectable in the organs of the eyes, but she was blind. Her condition was attributed to some fright the she received during the night. Her musical education continued and the blind infant prodigy was much sought after in royal courts throughout Europe. M—sought to cure her with magnetism, with some success, but Maria’s parents were not blind to society’s measuring rod and blind prodigy was a mere prodigy without her condition.

O’Sullivan notes that whilst psychosomatic disorders may be thought of an illness of perception, there’s no escaping the damning statistic that seventy percent of such disorders are suffered by women. She draws not just on local knowledge but a wide body of research. A 2011 German study, for example, showed that twenty-two percent of those attending the equivalent of our GPs had a somatising disorder. Somatising disorder means that although the illness the patient comes to get treated for is real enough for the patient those treating the patient can find no organic reason why he or she is presenting those symptoms. The World Health Organisation 1997 estimated that twenty percent of those attending their doctor had at least six ‘medically unexplained symptoms’.  More recent pilot studies in London confirms the WHO’s findings. They are the imaginary friend in the room with doctor and patient. Hollywood is good at this kind of thing. Think The Three Faces of Eve, but the patient has only brought two faces into the consulting room and is presenting with a bit of a cough. Some of the cases presented by O’Sullivan are highly symbolic and could be said to be straight forward. The woman that goes blind and is unable to keep her eyes open after her husband is taken to jail for abusing a neighbour’s child. Women that take pseudoseizures (or dissociative seizures) at work. The language is useful and how the patient describes their seizure has been modelled and analyses to differentiate between psuedoseizures and epileptic seizures. One behavioural, the other which can be accurately measured by EEG. With no increased electrical activity in the brain O’Sullivan asks and answers the question are they real? Yes and No.

O’Sullivan widens the scope to those outside her practice whom she has come into direct contact with. The estimated 250 000 reported cases classified as Myalgic Encephalomylitis (ME) and/or Chronic Fatigue Syndrome (CFS). Two million CFS cases are documented in The United States.  The disease or syndrome is real enough for those suffering from it. Each new case is looking for a cure, another test, another diagnosis.

The neurologist Weir Mitchell rest cure was a response to Charcot’s definition of hysteria in women extreme fatigue, but geared towards rich men in Philadelphia. The crème de la crème who were thinking too much and suffering from neurasthenia. Patients were force fed fatty foods to build them up. Discouraged from standing. A bedpan was brought to them for their toilet needs. They could not read. Have conversations, or have any type of stimulation. Although this sounds much like my local pub, they were charged extraordinary amounts of money for their cure. If the cure didn’t work, apply more cure.

Our government’s response is  predictable, a wooly response, to place wellbeing at the centre of their strategy; delay of the publication of critical report,  A Five Year Forward View for Mental Health; promises of more money for NHS Mental Health services, a mooted figure of £1 billion to ‘plug gaps in service’; whilst as Daniel Boffey notes ‘incentivising’ the 250 000 with recognised psychiatric conditions to find work by cutting currently classified as disabled from £102.15 per week to 72.40 per week. Using the government’s template those with ME or CFS could be ‘incentivised’ to be cured by cutting disability payments to a more manageable figure of £0.00.

As O’Sullivan notes most ME/CFS sufferers have good reason to be defensive. Whether in or out of employment, they are regarded as the shirkers of the medical system, using up valuable resources that could be used better elsewhere. The government diagnosis of a personal defect poor people suffer from that can be instantly cured by them finding a job and the cynicism of medical staff that grow weary of test after test finding no organic reason for illness and an increasing readiness to find the failing in the patient is a potent mix. O’Sullivan calls for ‘an open mind’ but that door is already closed.

‘Neurasthenia, hysteria, melancholia, depression, chronic fatigue syndrome, chronic fatigue immune dysfunction syndrome, myalgic encephalomyelitis, yuppie flu, dissociative seizures, psychogenic non-epileptic seizures.’

Hippocrates 200 AD suggested hysteria was too much or too little of something: black bile, yellow bile, blood or phlegm. If any of the four humours were in conjunction the trouble may be the master organ of the wandering womb and the sympathetic responses travelling in spirit form induced in the patient. I quite liked the nineteen-century idea of such conditions being down to engorgement of the nasal membrane, but then again I do have a big nose.

‘So now I’m a psycho, am I?’ asks more than one of O’Sullivan’s patients.

‘This is boring now, I think you should get better,’ Jo Marchant’s father says to his daughter in an extract of her memoir Cure.

As O’Sullivan notes, ‘In the twenty-first century psychosomatic illness is a socially unacceptable disorder’. The media plays its part in carrying the symptoms that are spread throughout the general population. But on the bright side we no longer burn people as witches.  Of course the condition, syndrome, illness or whatever label you want it put on it is a matter of perception and the votes are in. Any right-thinking type would know who can be cured will be cured, the others are psychos. In the same way the First World War the Krauts or Bosche needed more cold steel right up them to be pushed back patients with ME/CFS are a small minority of shirkers that need to find work is finding increasing traction. She is a voice of reason, but she is drowned out by those with louder voices, big sticks and the ability to push their agenda through. When we are told it is not a question of money, we can be sure it is.  O’Sullivan tells us ‘laughter can be therapeutic’. Ha. Ha. That sounds like a cheap option, but more tests will be needed.

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A budget holiday for the rich

george osborne budget

Thornwood (Steve) in AbcTales posts I hope the Tories have a change of heart about the planned cuts. 38 Degrees send me an email suggesting I contribute money so they can take out advertisements extorting George Osborne to think again. Dream on.

Notes on poverty (in no particular order).

Orwell suggest we need to state the obvious. Richard Hoggart wrote in The Road to Wigan Pier. ‘Each decade we shiftily declare that we have buried class; each decade the coffin stays empty’. Orwell, like Huxley, saw no way forward for the common working man in the 1930s. Mechanization would make him surplus to requirements.  There are parallels with the contemporary  turmoil in Greece. Then as  now, for example, with around  twenty-five percent of the population unemployed and fear for their future. John Steinbeck’s Grapes of Wrath caught a country’s angst. It described the  pre-war United States experience before and after Roosevelt’s New Deal. The Second World War parodied in Orwell’s 1984, in which each warring state blows up most of the products it produces, did save capitalism. The fall of the Berlin wall left it the only game in town.

Richard Titmus dictum: ‘service for the poor would become poor services’ have never seemed more apt.

Stewart Lansley and Joanna Mack in Breadline Britain point out the obvious: Britain spends below the average on benefits as a proportion of GDP.

The poorest fifth in Britain, for example, are poorer than Scandinavian countries, which you’d expect. But look at our close neighbours. Forty percent poorer than those in Germany or Austria and a third poorer than those in France.

Levels of statutory sick pay, short-term incapacity benefit and Jobseeker’s Allowance have been described as ‘manifestly inadequate’ by the Council of Europe which is hardly a hotbed of socialist revolution.

Jimmy Reid dead but still red.

To the students I address this appeal. Reject these attitudes. Reject the values and false morality that underlie these attitudes. A rat race is for rats. We’re not rats. We’re human beings. Reject the insidious pressures in society that would blunt your critical faculties to all that is happening around you, that would caution silence in the face of injustice lest you jeopardise your chances of promotion and self-advancement. This is how it starts and before you know where you are, you’re a fully paid-up member of the rat-pack. The price is too high. It entails the loss of your dignity and human spirit.

Robert Burns address To A Mouse ends in a field in Dumfries, a bleak December wind and a looking backwards and forwards and the realisation that the poor wee beastie, for all its troubles, is untouched by the past or future

Still, thou art blest, compar’d wi’ me!

The present only touches thee:

But Ouch! I backward cast my e’e,

On prospects drear!

An’ forward, tho I cannae see,

I guess an’ fear

Robert Tressel Noonan’s classic The Ragged Trousered Philanthropist fills many a void.

“Poverty is not caused by men and women getting married; it’s not caused by machinery; it’s not caused by “over-production”; it’s not caused by drink or laziness; and it’s not caused by “over-population”. It’s caused by Private Monopoly. That is the present system. They have monopolized everything that it is possible to monopolize; they have got the whole earth, the minerals in the earth and the streams that water the earth. The only reason they have not monopolized the daylight and the air is that it is not possible to do it. If it were possible to construct huge gasometers and to draw together and compress within them the whole of the atmosphere, it would have been done long ago, and we should have been compelled to work for them in order to get money to buy air to breathe. And if that seemingly impossible thing were accomplished tomorrow, you would see thousands of people dying for want of air – or of the money to buy it – even as now thousands are dying for want of the other necessities of life. You would see people going about gasping for breath, and telling each other that the likes of them could not expect to have air to breathe unless the had the money to pay for it. Most of you here, for instance, would think and say so. Even as you think at present that it’s right for so few people to own the Earth, the Minerals and the Water, which are all just as necessary as is the air. In exactly the same spirit as you now say: “It’s Their Land,” “It’s Their Water,” “It’s Their Coal,” “It’s Their Iron,” so you would say “It’s Their Air,” “These are their gasometers, and what right have the likes of us to expect them to allow us to breathe for nothing?” And even while he is doing this the air monopolist will be preaching sermons on the Brotherhood of Man; he will be dispensing advice on “Christian Duty” in the Sunday magazines; he will give utterance to numerous more or less moral maxims for the guidance of the young. And meantime, all around, people will be dying for want of some of the air that he will have bottled up in his gasometers. And when you are all dragging out a miserable existence, gasping for breath or dying for want of air, if one of your number suggests smashing a hole in the side of one of th gasometers, you will all fall upon him in the name of law and order, and after doing your best to tear him limb from limb, you’ll drag him, covered with blood, in triumph to the nearest Police Station and deliver him up to “justice” in the hope of being given a few half-pounds of air for your trouble.”

Owen’s fictional harangue seems rather dated and overblown. Let’s put it into modern parlance. George Ritzer’s attack on the fast-food industry and McDonaldisation as the ‘irrationality of rationality’. Let’s talk about leverage. In 2014 the UK’s GDP was £1.8 trillion. The financial sector was £20 trillion. Companies like Apple are listed on the stock exchange and worth nearly £1 trillion.

Jan Zalasiewicz’s research shows the earth is on the brink of the sixth mass extinction. The fault lies with us. Humans and the land vertebrates that we keep as a cash crop and to eat –pigs, cows, sheep, poultry etc—have pushed what we think of as wild animals such as elephants, giraffes and tigers to the fringe. We take ninety-five percent of resources and this is increasing and they take up five percent.

Pork, for example, is mass produced from cradle to grave. Ted Genoways shows how worker’s wages are driven increasingly downwards, their workload increased year on year by increasing line speed. Profits are increased, allowing vertical integration the takeover of more land, the growing of more corn crops to feed the pigs they produce and the use of their excrement as fertiliser to feed the land. One of the problems he identifies is the runoff of fertiliser (pig shit) from the land results in water pollution and leaving water undrinkable.  Half a million people in Des Moines, for example, could no longer safely drink their water because of an increased level of nitrates and E coli. Enforcement of the Clean Water Act was hampered by sacking workers who monitored the rivers. The kind of light-touch regulation we are familiar with. A saving and win-win situation. Only poor people drink water.

Catch 22. Major Major (senior) is a farmer in Mid-West. He hates Medicare. He hates social services. He hates the unemployed getting a hand out. He liked getting paid for not growing alfalfa in his fields. The more money he gets for not growing alfalfa the more fields he buys not to grow alfalfa. He knew how to make money and how not to make money. The poor were poor because they were lazy and didn’t work hard enough. Something needed to be done about them.

Corporate Ag gag laws where a triumph of corporate practice that even Joseph Heller would have chocked on. Cruelty to humans results in cruelty to animals as sure as pig follows shit. Animal abuse isn’t animal abuse if we don’t see it. Whistle blowers such as PETA who film or record such events are reclassified and prosecuted by the state as terrorists indulging in terrorist activity.

We are what we eat. Closer to home we eat the poor.

Rohan Silva: It’s no surprise that between 2010 and 2014 workers in London saw their wages fall in real terms by more than £3000 per year, even with (perhaps because of) global capital pouring into the city. Karel Williams of the Manchester Centre for Research on Socio-Cultural Change suggests the size of Britain’s bank fundamentally distorts its economic model. Let’s look at it sideways. Fifteen- percent of the population take seventy percent of all flights. Ninety-five percent of public expenditure on public works is spent on London, with this likely to increase with  Heathrow likely to add another runway. Daniel Boffey reports in The Observer the UK government has increasingly hampered progress in tax avoidance. To paraphrase R.H. Tawney the problem of poverty is the problem of riches.

They have fostered a climate of fear and mistrust. Al Alvarez in  The Writer’s Voice, discusses Edmund Wilson’s critique of New Criticism, but it works equally well with the politics of our Tory leaders and masters.

How, you may ask, can we identify this elite who know what they are talking about? Well, it can be said of them that they are self-appointed and self-perpetuating and that they will compel you to accept their authority. Imposters…demagogues [preaching] varieties of no nothingism.

Tory’s plan to redefine child poverty out of existence. One in five children live in a home that is cold or damp. Two-and-a half million children in poverty is not a true reflection our Tory masters claim. The Fabian society claim cuts to tax credits will hit the lowest paid, the working poor, and the largest group in society. Look back to the 1960s and 1970s and seismic influence of Peter Townsend’s The Poor and the Poorest, which became Poverty in the UK. Something had to be done. National soul searching. Debate. An increase in benefit levels.  Needs change over time but we all need to eat and have a roof over our head. With rising housing costs and reduced benefits, more people chasing fewer jobs, more people chasing fewer homes and almost a third of the population locked into wage and benefit free-fall something had to be done now. We’re budgeting for it.

Take for example the Mail on Sunday’s exposure that almost anyone could walk into a Foodbank and claim to be hungry and be given a free packet of pasta. No check on credentials. They could have been reporters that drove away in a car worth £30 000 and nobody stopped them. I must admit I’d like to have broken a wing mirror or two. But I’m not a pasta thief taking food out of the mouths of the hungry.

When I think of how our Tory leaders murder language and define poverty I think of my school days and the catch 22 before we were in a modern comprehensive secondary. The worst crime at school wasn’t burning down the school, it was refusing the belt for burning down the school. You could plead innocence. Become a grass and name the culprits. Tell the teacher you didn’t have any matches and were scared of fire and flames. The truth is you’d refused the belt and that was worse than burning down the school. Poverty is no excuse for poverty, it’s personal.

The Tory government focus on problem families. In a jointly funded church report The Lies We Tell Ourselves troubled families were estimated at around 120 000, and with typical Tory inflation this went up to 500 000. The flip side of that is these troubled families become the cause of the nation’s ills. Fecklessness became the common currency of what they were talking about and whom. They were infecting society. Benefit Street or any other documentary on Channel 4 or 5 will show the truth is out there. In the thirties this would have been called propaganda. Now its mass entertainment.

Owen in Tressel’s classic addressed it in this way. ‘What is the cause of the lifelong poverty of those who are not drunkards and DO work? Why, if all the drunkards and wont-works and unskilled or inefficient workers could be by some miracle transformed into sober, industrious and skilled workers tomorrow, it would under the present conditions be so much the worse for us, because there isn’t enough work for ALL now and those people by increasing the competition for what work there is, would inevitably lead to a reduction in wages and a greater scarcity of employment. The theories that drunkenness, laziness or inefficiency are the causes of poverty are so many devices invented and fostered by those who are selfishly interested in maintaining the present state of affairs…

Why is it…we are not only deprived of nearly all the benefits of civilisation, but we and our children are also unable to obtain even the bare necessities of existence.

If a man is only able to provide himself and his family with the bare necessities of existence, that’s man’s family is living in poverty. Since he cannot enjoy the advantages of civilisation, he might just as well be a savage, better, in fact, for a savage knows nothing of what he is deprived.’

How wealth is generated matters. As Henry J Ford, hardly a revolutionary figure says ‘if an employed does not share prosperity with those who make him prosperous, then pretty soon there will be no prosperity to share. Joe Stiglitz, Nobel Prize winning economist who predicted the 2008 crash and forecasts another, says much the same thing

Roman Abromavich docked his yacht Eclipse and took a cycle round the Isle of Arran this week. Let’s look at Bill Browder’s take on corruption. He spotted there was a killing to be made in the old Soviet Union of the 1980s and made hundreds of millions of dollars. The average gap between rich  and poor proletariat Russians was a factor of six. The richest Soviet citizen were worth six times the poorest paid. Poor old Roman. He cashed in his chips and jumped ship. Now according to Forbes he’s worth $9 billion. He did in one generation what it took the aristocracy far longer. The new rich meet the old rich in cities like London were wealth can be laundered.  His Eclipse eclipses the newly revamped Southern General Hospital which cost almost £200 million. But the Southern General Hospital is an asset that employs tens of thousands and generates disposable income that is spread in and around that area. The engine of the economy is disposable income. When people have nothing they spend nothing. But it doesn’t work in reverse gear. When the rich money has something he doesn’t spend.

Pope Francis who knows a thing or two about miracles describes ‘trickle down economics’. I’ll paraphrase in terms of Pinocchio, just when the snot of trickle is about to happen the needs of the rich man grows. His nose grows commensurately and he tells you he has not enough to meet his needs. Somebody else pays. The common man. The poor pay for the roads and docks and infrastructure and they educate rich and poor, but not alike. But in the current egalitarian tax system there is a  reversal of who pays more. In the 1960s and 1970s the top fifth paid more tax than the bottom fifth. That has been reversed. The rich man orders a tax avoidance scheme from an accountant in the same way that a bespoke suit used to be made by a skilled tailor.

Piketty shows that in mature economies such as Britain money grows at increasing speed and rate to the one percent that have money and own the land and assets that go with it. The answer is to tax the rich. Simple.  It would be a start. I wish some political party would start thinking in that way and not the hot air of no nothingism that we’ve come to expect so we no longer listen.

http://unbound.co.uk/books/lily-poole