Tuesday 28 August 2012

FOUR: My Hysterical Arm (those other explanations)

From - Psychogenic Movement Disorders:
Neurology and Neuropsychiatry by Mark Hallett


My father died when I was 32. Losing him, my quiet champion, was terribly painful.

     Can’t yet find the words to speak the burial
     Though I didn’t die – gasping –
     for you and faith receding – 
     down these oft-dreamt stairs.
     The Dali Lama’s Mother
     Brittle    light    reverent     still
     upon my upturned palm

Five months earlier he had been diagnosed with a brain tumour. I flew back from Montreal to Vancouver and found him standing at his hospital bedside cradling his left arm with his strong right hand, his wedding ring on a chain around his neck for safe-keeping.

A year after seeing him this way I was toodling along rue Sherbrooke ouest near boulevard St-Laurent when for no apparent reason I fell of my bike and broke my left arm at the elbow. As removable slings rather than casts are used for these breaks, I often found myself cradling my left arm…

I couldn’t help but sense his presence in my fall.

An elbow’s ache unhinged –
Reaching out for your right hemisphere –
I fell…

And later, in Sénégal, I found all sorts of good and bad things. 

The manipulative and cruel man who one day knocked me down (amongst too many other oppressions) being of the latter. An X-ray of my left elbow indicated no broken bones.

Sticks and stones may break my bones but names will never hurt me?

I find that that rather depends on the context. Being called a bitch isn’t such a big deal unlike being called by a name other than your own for his purpose of perpetuating a fraud against a school girl with whom he is having an affair in order to benefit from the resources of her family…

I’d only ever had nice boyfriends – I broke up with him or he with me. No evil.

A terrible vulnerability (engendered by the betrayal of our collective cause at my most interesting job followed immediately by my bio-mother’s rejection) had left me prey: frozen and powerless.

Once again, cradling my left arm.


Then with the beginning of the symptoms that eventually led to my PD diagnosis, my left arm was not only cold (and wrapped in an arm-warmer), it was also weak…

And there I was, once again, cradling my left arm.

hys•ter•i•a (h-str-, -stîr-)
n.
1. A psychiatric disorder characterized by the presentation of a physical ailment without an organic cause.
2. Excessive or uncontrollable emotion, such as fear.
hys•teric (h-strk), hys•teri•cal (h-str-kl) adj.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. 
 A Psychogenic disease is one that originates from the mind instead of another physical organ, i.e. the effect is psychological (non organic) rather than physiological (organic). It is brought on by emotional trauma. The body bears the burden…

The science of trauma is highly complex and as yet unmastered by specialists. I can therefore only speak from my limited and subjective understanding.

My left arm, which contracted “hysterically” and ultimately began to tremor, bears the burden of my traumas – losing my father, abuse where there should have been love and respect and, by association, the betrayals that left me vulnerable to that abuser – traumas embodied in the cradling of my left arm.

Before the PET scan I believed my disease was psychogenic because there were so many precipitating events and because of the symbolism of my cradled (hysterical) left arm.

Also, my symptoms weren’t initially so typical of PD. The tremor was not at rest but with effort, movement. In PD it’s usually the other way around – Michael J Fox wrote how when acting, if he felt a tremor coming on while he was not moving, he would incorporate it into some unscripted comedic gesture.


The onset was quite rapid – first symptoms to functional difficulty in a few months. Symptoms could be supressed, and still can be, by distraction. Unlike with PD, the frequency of my tremor varied in rhythmicity and in direction of oscillation.

However, patients normally resist the diagnosis of a psychiatric illness. Why would you prefer to have a psychiatric illness? Well in my case, because Psychogenic Parkinsonism is curable, Parkinson’s is not.

Maybe I was in denial. Maybe there is more to the story than depletion of dopamine-producing cells in my substantia nigra. Even if unanswerable, there is always a Why?