De Valera, Asperger’s and psychiatry

An article by Dr Tony Humphries in The Irish Examiner on autism provoked a furore in the Irish media and online. There are some troubling assertions in the article, and the author does not seem to have a very sophisticated grasp of the issues that he would seem to claim an expertise in. However, as I have previously chronicled in this blog, unscientific claims are not unknown to the medical or psychiatric professions, and often seem to coincide, in a most serendipidous fashion, with political expediency. And, as I noted in this blog post, Irish doctors are always on hand to assist in targeting the disabled. Having a need to procrastinate this evening, I’m going to write about an attitude to Asperger’s Syndrome that is influenced by 90-year old political propaganda and the mental health stigmas that it exploited.

A few years ago, Dr Michael Fitzgerald, who is a professor of Child and Adolescent Psychiatry at Trinity College, Dublin and has a private practice in Blackrock, wrote a book in which he claimed that certain figures in Irish cultural and political life bore all the signs of having had Asperger’s Syndrome. Entitled Unstoppable Brilliance: Irish Geniuses and Asperger’s Syndrome, the book’s list of Irish “Aspies” includes Robert Emmet, Patrick Pearse, Éamon de Valera, Robert Boyle, William Rowan Hamilton, Daisy Bates, WB Yeats, James Joyce and Samuel Beckett. Fitzgerald wrote that he wished, in connecting Asperger’s with achievement, to gain some social acceptance for eccentricity. So far, so noble, but while the book provoked complaints about the sheer number of such posthumous “diagnoses”, for me it raises a few serious questions about Dr Fitzgerald’s attitude to Asperger’s. Continue reading

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M.E. awareness day: the Politics of Disability

For M.E./Fibro Awareness Day 2010, I wrote a piece entitled In Denial, in which I described some of the methods used to discredit M.E. patients. In the wake of a medical breakthrough which linked M.E to a retrovirus, and the starkly contrasting PACE Trial, which purported to show that a complete recovery could be attained by the simple application of GET and CBT, the attacks have only intensified. According to Invest in M.E., the editor of The Lancet (where the results of the PACE Trial were published) described patient advocates as a very damaging group of individuals, who have distorted the debate. An Irish doctor was only honoured, your honour, to help out, and launched an attack on patients in the Irish Medical Times. The sexist subtext to the debate that I described in last year’s post is particularly present in Dr Monaghan’s opinion piece. It is a revival of the propaganda historically used to silence and marginalise women and the mentally ill. It is the sneer of the privileged at the vulnerable, intended to exploit feelings of powerlessness and arouse helpless anger.

As with the best propaganda, there is a grain of truth here. Among the effects of this multisystem disease are emotional liability and a loss of cognitive function. The struggle for articulacy and the occasional tendency to lash out can tell against us, a problem addressed by the CFS Report. One reason for the upsurge in attacks against advocates for M.E. is that, thanks in paret to the positive publicity gained by the work of the Whitmann-Peterson Institute, years of tireless work by patients, their carers and a group of courageous and hard-working medical experts, is starting to pay off.

The essential point to realise is that this is a political issue, and these tactics would not be used if it was not important. While the resistance to recognising M.E. is widespread, this particular language of abuse originates with English and Australian psychiatrists, many of whom, coincidentally, are bound to insurance companies. The PACE Trial cynically presents the notion, against reason, experience and several scientific trials, that patients with a chronic disease can recover by retraining their muscles and their brains. It is absurd, but there are interesting historical parallels. Jay Winter argues that, in certain places and at certain times, “shell-shock” ceased to be a diagnosis and became a metaphor. As Joanna Bourke shows, British soldiers affected by shell-shock were seen as abnormal: a cure entailed the recovery of “natural” masculine bellicosity. Shell-shock, then, was not so much an illness as a moral failing, which encapsulated the threat to Empire. Soldiers, post-war, were often treated as malingerers, their illness present but not real. Modern psychiatrists wield the threat of illness fakers, social welfare frauds who threaten to bankrupt the state (while bankers and politicians plunder and sell its resources), of working women who will cease to bear the disproportionate burdens that society places on them.

We exist, but we are not acknowledged. When we tell doctors that something is wrong, we might as well not have spoken. After years of crippling pain and the refusal of Australian authorities to provide treatment, Theda Myint tried to commit suicide and was committed to a psychiatric facility. The facility refused to provide any medical care whatsoever or to provide food that she could eat given her food intolerances.

M.E. is a disease that brings suffering, financial hardship, reduction of life expectancy and sometimes death. There is a choice between easing or ending this suffering, or increasing and prolonging it for financial gain. Few things are black and white, but this stands starkly as a modern human rights matter, perhaps marginal, but no less important for all that. This issue highlights the vulnerability of disabled people in general, and their potential to be abused and discriminated against. The greater exposure of M.E. issues highlights the debate occuring at the moment in the M.E. community about the need to discover a common platform to speak from a position of strength and the consiousness of right, for those who are unable to speak for themselves. That is the mark of true civilisation.