Providentia

His Last Request

Robert Baldwin is a familiar name to Canadian schoolchildren. He continues to be remembered as a bold political reformer and one of the architects of the first responsible government in Canadian history. Despite his prominence in Canadian political history, Baldwin's private life and some of the peculiarities surrounding his death in 1858 are not so well-known. His marriage to his first cousin, Augusta Elizabeth Sullivan, in 1827 was reluctantly permitted by their parents despite concerns about Eliza's chronic poor health and the potential risks of such a close genetic relationship to their children. As Baldwin's political career flourished, their family grew and they would have four children in all. Eliza's health took a turn for the worse following the caesarean birth of her last child in 1834 and she would die two years later. Robert Baldwin was devastated by her death and would never be the same afterward. His strong religious beliefs and obsession with the perfection of his life with Eliza kept him from ever marrying again. He also made yearly rituals out of the anniversaries of their marriage and her death. After spending the rest of his life in and out of politics, he ended his career in 1851 having been driven out by the very reformers he had championed. Baldwin spent the last years of his life tending to his estate in Toronto, writing letters, and brooding over the loss of his wife. He also became preoccupied with health problems which seemed primarily due to chronic depression. His eldest daughter, Maria, was his main caregiver during his last years. She had never married (probably because her father chased off every potential suitor she ever had) and became an embittered spinster who was devoted to her father. Caring for him became increasingly difficult due to his chronic headaches, memory problems and frequent "harassing and perplexing dreams" that disrupted his sleep. Still, it was only after his death on December 9, 1858 due to lung problems that things really took a bizarre turn.

Before his death, Baldwin had left a remarkable document with Maria that showed the full extent of his preoccupation with Eliza. The document contained nine requests concerning how he wanted to be buried. Not only did he ask that certain prized possessions and her letters be buried with him, he also insisted that their coffins be chained together. The most memorable request however was that "an incision be made into the cavity of the abdomen extending through the two upper thirds of the linea alba". In other words, he wanted to have an incision made on his body to match the caesarean scar that had been made on Eliza's body. Maria arranged for the other conditions to be met but balked at that last request and, believing that she had the only copy of her father's document, made no mention of it to the rest of the family. The funeral drew one of the largest crowds Upper Canada had ever known as Baldwin was laid to rest. Life went on afterward until one month later when Maria's elder brother, Willocks, came across a second copy of the document while sorting through his father's clothes. Robert Baldwin had been in dread of dying away from home and had carried an abbreviated copy to ensure that all of his final requests be met. Being a dutiful son (and with perhaps a few harsh words to Maria), Willocks made the necessary arrangements.

It was on a cold January day in 1859 when Willocks, along with several family members and friends (including Dr. James Henry Richardson), entered the vault where Baldwin's body was kept to make the requested incision (as it was still winter, the body could not be buried until the ground thawed in the spring). It was definitely a grave undertaking (sorry, couldn't resist) and marked a strange end to a remarkable political life. Robert and Eliza Baldwin are now buried in St. James Cemetery in Toronto (still chained together) and their joint grave marker represents a silent testament to a story of love and grief.

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Does Childhood Suicidal Thinking Predict Later Suicide?

An article in the November 2007 issue of the Journal of the American Academy of Child and Adolescent Psychiatry presents the results of a longitudinal study examining whether childhood suicidal thinking is related to mental health problems in adulthood. The study sample was made up of 1,022 Dutch children who were 11 years or younger in 1983 and who were followed over 10 to 14 years into adulthood. The study participants were assessed with a structured psychiatric interview to identify potential adult mental health problems including substance abuse, mental illness, and suicidal behaviour. Childhood suicidal thing was identified using using parental reports of suicidal thinking. The results indicated that childhood suicidal thinking was highly predictive of suicide ideation in adulthood and lifetime history of suicide attempts. Childhood suicidal thinking was also associated with an increased likelihood of mood disorder and anxiety disorder in adulthood as well as externalizing disorders such as ADHD, conduct disorder and behavioural syndromes. The authors conclude that suicidal thinking in childhood may be remain stable over time with worrying consequences in adulthood. Children with parent-reported suicide ideation at a young age may require additional resources, age-appropriate intervention, and careful monitoring into adulthood.

Click here for the abstract.

Happy Holidays

Happy holidays wishes to you and yours! For those of you who celebrate Christmas, may the day bring you good tidings and glad times. For those of you of other faiths, may the season be a good one for you and your families!

The Snakeroot Remedy

Rauwolfia serpentina is an evergreen shrub with large leaves and flowers and tiny fruit that turn purple-black when ripe. It grows wild in India and is mainly found on the slopes of the Himalayas. The first recorded mention of rauwolfia roots (known as snakeroot or "sarpagandha" in Indian medicine) was in 600 BC although oral tradition describes it as a mainstay of Indian Avuredic medicine for thousands of years before that. Snakeroot gained its name as a treatment for the effects of snake venom but it was also used for treating insomnia, diarrhea, dysentery and uterine complications. Traditional healers also used it for the sedation of mental disturbances and it became known as the "insanity herb" for that reason. Rauwolfia serpentina was given its scientific name in the 17th century by a French botanist who named the shrub in honour of 16th century botanist and physician Leonhard Rauwolf. Still, its medical properties weren't formally identified until 1933 when Rauwolfia's value in combating hypertension was first discovered. The active alkaloids derived from the rauwolfia root (more commonly known as reserpine) were first isolated and synthesized in 1952 and research into reserpine began in earnest. Researchers found that reserpine affected norepinephine uptake, activated dopamine receptors and depleted brain serotonin. The calming effect that reserpine had on patients suffering from acute psychosis was first identified in 1954 and the psychopharmacological revolution in psychiatry was on.

It was reserpine, along with chlorpromazine (which was actually first used in psychiatric patients) and haloperidol that triggered the massive deinstitutionalization of psychiatric patients that followed. In the United States alone, the number of hospitalized psychiatric patients went from 500,000 in 1960 to an estimated 100,000 at present. While the introduction of psychiatric medications gave rise to an irrational optimism about the treatability of mental illness in the community, the reality proved to be considerably bleaker for all too many psychiatric patients. Sadly, while psychiatric medications prove useful in controlling mental illness in institutions, using them for outpatient treatment is far more problematic. I won't go into the various economic, social and political dimensions of the tragedy but the end result has been a widescale shift in patients from psychiatric hospitals to homeless shelters, prisons and alleyways throughout most of the industrialized world. Ironically, reserpine has long since been phased out as a treatment for mental illness in favour of more effective medications due to the serious side effects associated with it (including neuroleptic malignant syndrome and parkinsonian symptoms). It's mainly used as a treatment for hypertension these days (except by traditional healers). The social upheaval that it helped spark is still unfolding though and the political and social will to deal with this health care crisis is sorely lacking.

The intricate details of how Indian herbal medication led to this current situation mean little to the former mental patients who find themselves locked in prisons or freezing on the streets this winter. All that I can say is that I am thinking about them this holiday season. I wish there was an answer for them.

What Causes Postconcussion Syndrome?

The causes, diagnosis and outcome of postconcussion syndrome (PCS) remain controversial, especially following mild traumatic brain injury (mTBI) . An article in the August 2007 issue of the Journal of Neurology, Neurosurgery and Psychiatry describes the results of a prospective study examining the role of preexisting psychiatric disorders, demographic factors, injury-related characteristics, neuropsychological and psychological variables in shaping acute PCS. Using a sample of 90 traumatic brain-injured admissions to a Level 1 trauma hospital and 85 non-brain injured trauma controls, participants were given a battery of neuropsychological and psychological tests and a PCS checklist. Statistical analyses were used to predict acute PCS after 5 days postinjury. The results indicated that diagnosis of acute PCS was not specific to mild traumatic brain injury (mTBI 43.3%; controls 43.5%). Pain was found to be a significant factor but the the strongest predictor for acute PCS was previous history of affective or anxiety disorder. Females were 3.33 times more likely than males to experience acute PCS but the role of acute posttraumatic stress and neuropsychological function was relatively small. Higher IQ was also associated with acute PCS. The authors concluded that there is a high rate of acute PCS in both mTBI and non-brain injured trauma patients and that PCS was not found to be specific to mTBI. For this reason, the use of the term PCS may be misleading as it incorrectly suggests that the basis of PCS is a brain injury.

Click here for the abstract.

Russian Activist Being Held in Psychiatric Hospital

In a disturbing development by the Russian government, opposition activist Artem Basyrov was detained by two plainclothes officers and sentenced to be held in a psychiatric hospital in the central region of Mari El. The November 23 arrest is the latest in a series of psychiatric committals directed against political figures and journalists critical of the current regime. The psychiatric board that reviewed the 20-year old Basyrov's case alleged that he had "harassed" a woman and was suffering from "some sort of mental illness". Basyrov's supporters dismiss the allegations as "idiocy" and maintain that his arrest was designed to punish him for running as an Other Russia candidate in the local legislature. Basyrov was one of the organizers for a "Dissenter's meeting" that was scheduled to take place on November 24th. The other organizer, Mikhail Klyuzhev, was arrested on November 22 for "hooliganism" and held for three days. While his Basyrov's is scheduled for review in a few weeks, international organizations such as the Global Initiative on Psychiatry have been monitoring the increasing use of psychiatric hospitals for jailing dissidents and accuse the Russian government of engaging in Soviet-era tactics to crush opposition.

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Travelling to Mars

While spirit mediums and trance channellers come and go, there has never been anyone else quite like Catherine Elise Muller (more commonly known as Helene Smith). Born in Geneva, Switzerland in 1861, Catherine`s father was a Hungarian merchant with a talent for learning languages and her mother was prone to seeing ``visions``. From an early age, Catherine had a vivid imagination and extremely intense daydreams. She would tell her parents of her visions of brightly coloured landscapes, bizarre images, and bright lights and openly speculated about being a changeling. It was in 1891 that she was first introduced to Spiritualism and quickly showed a remarkable talent for automatic writing. She also showed a knack for mediumship and communicated with different spirits (including the ghost of Victor Hugo). Table-tipping, spirit writing, clairvoyance, Catherine did it all. Her spirit guide, Count Cagliostro (more commonly known as ``Leopold``) acted through her body and she claimed not to remember anything that occurred while she was in one of her trances . Surprisingly, Catherine never charged for her séances and supported herself as a shop-worker despite her growing fame throughout Geneva.

Over the next few years, some astounding revelations came out of Catherine`s séances. These revelations seemed to move through specific ``cycles`` including an Oriental cycle in which she remembered her previous life as Simandini, the wife of Prince Sivrouka Nayaka of India (she spoke in a form of Hindustani during these trances). There was also a Royal cycle in which she remembered having been Queen Marie Antoinette of France, complete with French language, different handwriting, and recall of life in the French court (her humble life as a shop-worker was part of her karmic debt for the excesses of her life as the French queen). Catherine`s most remarkable claim occurred in November, 1894 when she stated that her spirit had been transported to the planet Mars. Not only did she describe the Martian plants and animals in detail, she also provided examples of the Martian language (complete with written samples). She later reported visits to Venus and Uranus (and provided samples of the different languages spoken there).

It seemed only natural that she become the subject of interest by Theodore Flournoy, professor of psychology at the University of Geneva and an early psychic researcher. He had investigated spirit mediums across Europe and Catherine became his most famous case. He became part of her spiritualist circle in 1895 and managed to gain her trust (a process made easier since Catherine declared that he was the reincarnation of Prince Sivrouka). Their association continued until 1900 when he published his book From India to the Planet Mars: a study of a case of somnabulism in which he provided a critical review of Catherine's mediumship (he changed her name to Helene Smith in the book and it is by this name that she is most famous). It's a fascinating book still and represents an early classic in scepticism (although he loses a few skeptical points by suggesting that Helene had genuine psychic powers). Sadly, from the perspective of Catherine and her supporters, Flournoy concluded that there was nothing supernatural about Catherine/Helene's trances. Not only were her revelations based on her own romantic ideas and misconceptions, but her Martian language was based on Earth languages (although it's still one of the most memorable examples of idioglossia on record). Despite the book being a best-seller and generating tremendous interest in Catherine, she and her supporters felt betrayed by Flournoy and terminated all contact with him.

Until his death in 1920, Flournoy continued his work with other psychics and also remained one of the seminal researchers in the area of dissociation and the unconscious. Carl Jung regarded him as an early mentor and credited him with spurring his own work into unconscious phenomena. As for Catherine? It was in 1900 when an American spiritualist (inspired by Flournoy's book) offered Catherine a generous salary that enabled her to quit her job and become a full-time spiritualist. Until her death in 1932, she continued her séances and proceeded on to a "Biblical" cycle in which she began painting while in trances. While her paintings tended not to be that memorable, she was regarded as an icon by later Surrealist painters who considered her to be an inspiration for their own art. So, in a sense, her work lives on in art galleries around the world. Otherwise, even spiritualists tend to view her as a bit of an embarassment. Needless to say, the scientific community never battered down her door trying to learn about life on other worlds.

Fournoy's book remains a classic and, for a time, was much better known than Freud's The Interpretation of Dreams which came out the same year. Even stripped of the supernatural elements, Catherine Elise Muller remains an amazing example of the power of human imagination and its capacity for self-deception. It's something that we should continue to remember.

Victims Behind Bars

The August 2007 issue of Psychiatric Services presents the results of a study examining rates of sexual victimization among prison inmates with and without a mental disorder. Using inmates aged 18 or older in 13 prisons within a single mid-Atlantic state prison system (12 facilities for men and one for women), a total of 7,528 inmates completed the survey which was administered by audio-computer-assisted technology. Of the 6,964 male respondents, 58.5% were African American, 16.2% were non-Hispanic white, 19.8% were Hispanic, and 5.5% were of another race or ethnicity. Of the 564 female respondents, 48.4% were African American, 30.9% were non-Hispanic white, 14.4% were Hispanic, and 7.3% were of another race or ethnicity. Determination of history of mental disorder was based on self-reported previous treatment for particular mental disorders. Sexual victimization was measured by using questions adapted from the National Violence Against Women and Men surveys. The result indicated that approximately one in 12 male inmates with a mental disorder reported at least one incident of sexual victimization by another inmate over a six-month period, compared with one in 33 male inmates without a mental disorder. Among those with a mental disorder, sexual victimization was three times as high among female inmates (23.4%) as among male inmates (8.3%). African-American and Hispanic inmates with a mental disorder, independent of gender, reported higher rates of sexual victimization than their non-Hispanic white counterparts. The authors conclude by recognzing the hazards of prison life and call for the need to protect vulnerable inmates from predators inside prison. Screening for posttraumatic stress disorder and providing trauma-related treatment are vital.

Click here for the abstract.

Chaining the Wizard

An 84-year old Ghanaian is facing legal charges for allegedly keeping her 50-year old son chained up in a single room for ten years on suspicion of his being a wizard. Kofi Menka, a former businessman and member of the Dome Royal Family in Offinso, Ghana is reportedly suffering from malnutrition and mutism as a result of his long incarceration and has been placed into the care of his younger brother. Journalists visiting Menka have indicated that "his beard, mustache and head had not seen razor for several months while his nails have grown long". Authorities have advised Menka's brother (who is also the current Dome chief) to send him to a psychiatric hospital for specialized care.

While an official complaint has been laid against Menka's mother, Akua Bio, with the Offinso police, the Committee of Human Rights and Administrative Justice has yet to launch an investigation. According to family sources, she had Menka imprisoned after he had been cursed by a female trader.

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Keeping Up Appearances

One of the most memorable figures of the eighteenth century must surely be the Chevalier Charles D'Eon(or Chevaliere Charlotte D'Eon as he became more famously known). Born in Tonnerre, France in 1728 to a distinguished family, Charles Geneviève Louis Auguste André Timothée Éon de Beaumont completed his education in 1749 and began a diplomatic career. He also became a spy for King Louis XV and took part in an espionage mission to the Russian court. While dressed as a woman, he became a close associate of the then-Empress. Later, posing as the uncle of the woman he had previously pretended to be, he reportedly convinced the Empress to sign an important treaty with France. After returning from Russia in 1761, he became a military officer and fought in the Seven Years War. When the war ended in 1763, along with a decoration for bravery, he also earned the rank of Chevalier and a position with the French embassy in London. As a favourite of English society, D'Eon was in a good position to remain in England after a quarrel with the new ambassador prevented him from returning to France. He took revenge by writing a best-selling book that scandalized the English and French courts and D'Eon lived in England as an exile for fourteen years. Until the rumours started...

D'Eon's boyish appearance, absence of facial hair, and lack of interest in female companionship led to speculation that he was really a woman. Allegations concering his gender arose in England and in France and became the subject of substantial wagers. It was a trial in 1777 before Lord Mansfield that forced the rumours into the open. The grounds for the trial were straightforward enough: a surgeon named Hayes had made a substantial bet with a broker over whether D'Eon was really a woman. While D'Eon was not directly involved, the humiliation caused by the trial led him to quit England and return to France. King Louis XV had died by this time and his successor, Louis XVI was less kindly disposed towards him. D'Eon was told on arriving in France that the King had issued a decree that he "should resume the dress of his sex"

The Chevalier took the King at his word and, for the rest of his life, dressed and behaved like a proper French lady (in addition to a pension, the King also provided D'Eon with funds for a new wardrobe). He later claimed that he had been born a girl but that his father had raised him as a boy to ensure an inheritance from his in-laws. In 1779, Chevaliere D'Eon (as he was then called), published his (probably ghostwritten) memoirs La Vie Militaire, politique, et privée de Mademoiselle d'Eon. When the American Revolution broke out, D'Eon asked for permission to abandon his female dress and join the military but his offer was rebuffed. D'Eon returned to England in 1785 and stayed in London until his death in 1810. The French Revolution brought an end to the royal pension on which he had been living and he spent the last years of his life supporting himself by participating in fencing demonstrations (until an injury forced an end to his fencing career). His efforts to complete another autobiography never got past the planning stage and he died in poverty. It was only when his body was laid out for burial that (as one contemporary writer described it): "death proved the folly of those who had forced him into petticoats; for his manhood was placed beyond all doubt by an anatomical examination of his body". Even though he had lived with a woman, Mrs. Mary Cole, for the last fifteen years of his life, she had never suspected that he was really a man. He is buried in St. Pancras Cemetery in London where his grave still attracts visitors.

Despite various attempts at attaching a proper diagnostic label to describe the Chevalier's gender-bending life, he continues to defy classification. His case gave rise to an early term for cross-dressing, eonism, although it is has since fallen into disuse. Was D'Eon a transvestite or something more? His absence of facial hair and effeminate features suggest that he may have been a transsexual although there is insufficient information to tell either way. So, much like James Barry with whom he has been often compared, the Chevalier D'Eon remains a mystery long after his death. Perhaps that's the way that he would have wanted it.