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Mental health and homeostasis

My parents are both psychiatric nurses who worked their entire careers in state-run mental health facilities. In Casey, there is a line from the Director (on p. 151): “There is pleasure in a schedule…. It calms the mind.” This made me think of conversations I’ve had with my parents about the difference in the states of clients (which is the present term for people who’ve been admitted to state-run facilities) before and after admission/re-admission. It seems to me that in many cases, the pre-admission state, untreated, is the body’s current, tended-toward state (for various reasons… nature/nurture/both/other), and while admitted, clients are being treated to calm or control the pre-admission state, including its effects on the client’s actions and interactions; in facilities, clients are subdued, in a sense, by layers of predictability. During admission, having a schedule is emphasized, as well as taking care of the body and its environment at intervals throughout the day, including personal hygiene, maintaining orderly surroundings, taking medications, and doing both individual and group therapy work. The atmosphere of reliability and constancy is an attempt to engender a homeostasis so that volatility is less frequent, and individuals and groups are less disrupted psychologically than when left to their own previously tended-toward states/environments. Once discharged and returned to their pre-admission environments—which happens for a variety of reasons (family needs, funding, level of remission of symptoms)—many clients relapse for different volatilities, but also because medication and therapy schedules are not continued properly or are often abandoned entirely.

Thinking about travel in relation to the self via our readings this week was interesting in that change in environment can be change in perspective (separation, renewal, etc.). We touched on this notion in class discussion last week, when we discussed how someone might be A in B environment, but X in Y environment. The fugueur seems like an example of change in self via wandering, movement, and/or escape, whether conscious or not; that the fugueur’s travel is the self unanchoring from (at least one specific) place, as well detaching from homeostatic-rich things like (being able to work toward maintaining) a job, home, marriage/family, and/or planning a future. This made me think of Jill Bolte Taylor’s comment about schizophrenics and how their reality is not always linked to a shared/common reality of past, present, and future, or a plan within an overarching framework beyond their own (paraphrased). This idea that someone experiencing a mental illness might be less aware of the self in relation to a greater collection of selves, or that sometimes that experience is characterized by acting to escape homeostasis is interesting. Even when someone is free of the challenges of acute mental illness, certain levels of self-awareness and self-monitoring, as well as trying to adhere to relative homeostatic conditions day in and day out, can be difficult (and/or a struggle to maintain over time).

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2 Responses to Mental health and homeostasis

  1. Yeah, just when you thought we were done with Damasio, he’s back 🙂

    I thought the travel background in Hacking was so interesting! Thinking about how motility (bikes, railroads, and transferring from one place to another in city hubs) affected individuals, regions, and the masses in various ways (from economic to political to psychological); that the time period was a cusp between travel for the rich and bringing it to other folks, and how that affected a person’s sense of self and idea of freedom/escape. More accessible travel methods would naturally give people an outlet to desire newness, difference, and possible re-invention… or just that they could be somewhere else, if even for a few days… to get away for a variety of reasons. It wasn’t just the stuff of books or the newspapers anymore.

    In terms of mental illness, my parents have the most extreme experience of caring for highly affected individuals with chronic conditions (severe schizophrenia, bipolar/borderline, and conditions like polydipsia). Their clients were people who could be a danger to themselves and others. They had chronic histories that responded most to reliability of environment, soothing of symptoms, and focused care/monitoring, but were not cured by these things. My parents would say that medications helped people (especially in concert with therapy/care), but never entirely cured anyone, of course. I think they’d agree with the things we are discussing regarding breaks in self-consciousness and self-awareness–that there is some kind of disconnect between the biology/neurons and/or environment/nurture–that contributes to severe mental illness so that people can’t fully tap into that collective notion of past, present, and future. My parents’ focus was always on the actual caring for people, though, versus the hows and whys of the differences in consciousness. They know a lot about the behaviors that breaks cause, medications and their uses/side effects, and being prepared for minds that can change at the drop of a hat. Their clients were always people first, though, to them, and their illnesses and symptoms second. I’d say their goal at this certain level was to get people the most time without discomfort or disruption in personality and behavior.

  2. Liz Foley says:

    Nice application of the Damasio concept of homeostasis to a non-Damasio text! Now if we can just figure out whether Albert’s walking is a function of his core self or a self-obliterating gesture on the part of his autobiographical self, we’ll really be in business. 😉

    What you’ve said about travel reminds me of the two epigraphs at the beginning of Casey. The one by Robert Louis Stevenson seems like an unwittingly apt description of Albert’s motivations and experiences in walking, until you recall that Stevenson is giving up the “feather-bed of civilization” voluntarily and Albert isn’t. Stevenson also doesn’t appear to be running from something, as both Albert and the Doctor seem to be doing with their travels (as when the Doctor flees from the implications of Albert’s nihilist assassin lie to Paris, which doesn’t really make sense except as a device whereby Casey can give him his own fugue episode).

    I wonder what your parents would make of the texts in this course! Do you think they’d be in sympathy with any of the theories our authors have put forward?

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