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5-V Extract the doctoral thesis of Dr. Peter Kahn cyclothymia (1909)

I landed by chance on a U.S. website called ASKPATIENT.COM. This site is quite interesting and at the same time may seem absurd because it lists all the opinions on drugs. Patients record their medication!
It is obvious that the strength and especially the molecule acts differently on each individual. Take 200 mg of Lithium per day is not the same thing to take 1500 mg.
However, it is true that the fear of side effects remains the main reason for patients to abstain from taking drugs. Some have no choice, if other, and sometimes opt for CBT, psychoanalysis, alternative medicine. This is the case cyclothymic.

As I wrote in my book on creativity and cyclothymia, I have not had a real need to take drugs, but maybe one day I will be forced and I do not have problems .

For me the question is how far I can deal with my strength willingness to get out without therapeutic help. The price is high, I admit. But I'm used to 20 years because I'm very disciplined about healthy living but also on my personal ethics (including professional). This saves me but I can not say I'm happy but I do not care because I find offsets.

Once again, it's a personal question and I hate all the people who force you to take drugs than those who try to dissuade you. This is a personal matter and especially for cyclothymia. However, we must assume in both cases did not complain. Mostly it's that rattle around or rejects the bipolar-manic and think it is sick when in fact it is often in a bad environment (goodness of fit).

Psychiatrists as David Healy ("The Time of Antidepressants" or his article in Courrier International No. 820) are critical of certain drugs taken for long periods.

Most doctors often assumed that cyclothymia is a neurosis, hysteria or borderline, and finally it's not so bad compared to real bipolar ... This is obviously false because the harmful effects and invisibility of cyclothymia are far more dangerous than the BP I, well cared for.

By cons, Healy may be right when he speaks of "pharmaceutical marketing", referring to the campaigns to encourage take drugs because it is ultimately the laboratories that fund these actions. This is called DISEASE mongering. At the same time if this helps diagnose new cases and what is wrong? We face a complex situation.

It's amazing that with the same molecule, each patient reacts differently ... We therefore also perceives the limits of science to treat mental disorders because the brain is a very complex!

What I find interesting about the approach ASKPATIENT is the democratic, transparent and ultimately cathartic this site. People talk about their disease free and they do not live as we do under the influence of the environment and therapists (who often do not know what they treat). The "patient-pattern" exists in the United States, France will have to wait at least 10 years ... We must remember that freedom is a real value there and that here the principle of equality prevails despite hypocrisy that means.

Personally, I think that if society was less selfish, materialistic, rigid and if people were able to truly love, there would be fewer psychiatric consultations. This may sound naive and simplistic but I think it's a reality. I reread last year's wonderful biography of John Nash not Silvia Nasar in which the Nobel Prize said that without the love of his wife he would never do it out (its schizophrenia).

For the bipolar case lighter, people are turning to doctors because they annoy those around them or they hate themselves or are unaware of themselves ...

Drugs should be a temporary means a crutch to get through the SOMA and not a new concern as the Professor Kramer in the "Order of Happiness."

As I wrote earlier we enter the era of a new eugenics that TS Eliot in 1939 called "the puritanism of a legal officer in the service of efficiency" (see also Alain Ehrenberg and " Tired of being self ") and medicines no longer represent a danger to the body (the side effects are less and less real with the new generations of molecules) but to the spirit and moral integrity.

In this context I share many principles pharmacological Calvinism advocates who believe that suffering is the idea of constructive we want to ban. So says Professor Dyck, a specialist in bioethics at the University of Harvard, or Dr. Tixier (Praise of the Depression that I mentioned in a previous post) and Peter Kramer: http

: / / www.cbhd.org/resources/endoflife/dyck_2003-11-12.htm

http://en.wikipedia.org/wiki/Listening_to_Prozac

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"In politics, nothing happens by chance. Whenever an event occurs, you can be sure he had been scheduled to take place as well."

Franklin D. Roosevelt
United States President (1933-1945)

"The world is divided into three categories of people: a very small number that actually occur events, a slightly larger group who watches their performance and looks accomplished, and finally a vast majority who never knows what happened in reality. "

Nicholas Murray Butler
President of the Pilgrim Society, a member of the Carnegie, a member of the CFR (Council on Foreign Relations)

"France does not know, but we are at war against the United States. A permanent war economy, a war without blood. "
" Yes, they are very Americans hard, they are voracious, they want undivided power over the world. An unknown war, permanent war, without apparently dead, and yet a bloody war. "

Mitterrand
Comment made during a private meeting at the end of his life (quoted in Courrier International of April 13, 2000)

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Should we be afraid of drugs?


In the section on etiology, Dr. . Kahn notes that "the excesses of any kind can a priori by causing fatigue, upset the balance so precarious cyclothymic. But among the excesses there are two on which we wish to emphasize: the excess
alcohol and sexual excess. "

" Alcoholism as dipsomania, cause he's fit of melancholy or excitement, or is it itself a form cyclothymia? And then there would be a vicious circle: because alcoholic and cyclothymic cyclothymic because an alcoholic. " It is evident that alcoholic saying we only hear about the dipsomaniac, the alcoholic in crisis. "

" The money worries, family quarrels, bring a moral fatigue which, more than physical fatigue, leads to a more severe disorder of mood.

"At one of our patients, who in his time excitation was distinguished by a special malice, wickedness so prevalent among cyclothymic, his entourage could provide access by the slanders spread it over the conduct of his mother. "

" We must, however, whether reputation for originality, instability that is attributed bohemian writers and artists is not a reflection of cyclothymia Constitution? "
" For the public, he sees these individuals as long time and has no chance to see them when they are confined to their homes, he can not suspect the disease state in which they are found for several months, and when he reappears later, arises when the period of excitation, they found as he had once known. He believes when an eccentric character, gay and spiritual and feverish activity, as we observed in a few exceptional individuals, but he can not suspect the existence of such a condition. Such is the degree
the lightest and most often overlooked in the madness circular, compliance with which may be made outside of lunatic asylums. "

" Having fully aware that he feels "next "he can no longer rely to himself, that his feelings are somehow perverted the cyclothymic remains unbalanced, as disoriented (...). It is sad, scared, supporting life as inevitable as a millstone that unknown power was glued to his foot, and he does not even try to get rid "


" Consciousness is intact. The cyclothymic knows he is sick and desperate to heal. It was so conscious of his condition he would himself visit the doctor and ask for a remedy against his moral suffering ".
" It did, "he said (one patient), never completely erased, c ' disease is indefinable which must be eradicated from the beginning. "
" But the excitement as depression are one and the other the flow and ebb of the same imbalance of moral sensitivity. "

Excitement cyclothymic :

"If the letters of manic depression have given us valuable support in the study of their feelings, it is not the same for the cyclothymic in its period of expansion.
This one is no confidence, it does not reflect on itself. "

Gislaved Nordfrost 5 Vs 3

4-Excerpt from the doctoral thesis of Dr. Peter Kahn cyclothymia (1909)

In its definition of cyclothymia, Peter Kahn explains


" The Cyclothymic is not a lunatic, it is not a perfectly normal person and it is strange, original, bizarre ".


" It is too gay or he is too sad, too restless or inaction strange, too indifferent or concerned with what does not concern him, undecided excessively or too rash in his undertakings. It is still too ... or not enough ... He has no sense of proportion, but not insane. "

" Their character changes, "said M. Huchard, like a kaleidoscope of views, which was able to say with reason by Sydenham that what is more constant among them is their inconsistency.

"Half the time in the world of people who are considered normal and the patient's vein, cyclothymic belongs to both:" I know I'm in the lobby of madness "we said a of our patients. Is not that a good definition of cyclothymia? "
"So it is very difficult to say which begins and ends cyclothymia originality."

"The excitement when not diagnosed" hysteria ", almost always goes unnoticed; depression instead, alarm around easily. It makes the physician the patient. The label of neurasthenia (...) is usually given but if these problems have worried the family, which therefore would dream about him to be regarded as morbid hyperactivity (...) his demonstrated in its period of excitement? "

" All that we can say is that the cyclothymic aware of his condition, he did not have delusions or hallucinations and, therefore, for these characters, it separates from certain forms and some degree of periodic psychosis.

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3 - Extract from the doctoral thesis of Dr. Peter Kahn cyclothymia (1909)

In his history of cyclothymia (meaning in Greek: mood ring or circular mood, he makes it clear that
"cyclothymia is not a psychosis and it is not a normal character psychique.C life is somehow a very mild disease, a through: Border immediately preceding the pathological."


He continues: "In cyclothymia no function of the mind is reached. Humor is simply confused. There simply dysthymia. It's just a disease of emotional sensitivity, sometimes Hypothymis sometimes hyperthymic. These disorders are also so light that one has never detain the patient. In 1898, still in Germany, Hecker said the issue of cyclothymia "disease Circular emotional sensitivity "(Gemuthserkrankung). He observed with great accuracy the periods of excitement often escape the attention of the doctor because the patient and his entourage as normal considèerent (...) It highlights the so-called "free interval" between the two phases of the disease that never leads to mild dementia, madness.
It shows that, in reality, these intervals are not free, mood with daily changes "

Mr. Deny shows that many patients labeled psychasthenics, neurasthenic hereditary or constitutional within the scope of the cyclothymic, ie unbalanced moral sensitivity (...).

One can not distinguish truth from make or draw a boundary line between acute and cyclothymia just a milder form of puerperal psychosis.

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2-Preview of the doctoral thesis of Dr. Peter Kahn cyclothymia (1909)

As I announced in my penultimate post on the "old new disease" cyclothymia what I propose to share with you excerpts from doctoral thesis published by Dr. Peter Kahn G. Steinheil in 1909. to restore the truth about its history and cyclothymia.
This work shows that some doctors French researchers at the time knew exactly what cyclothymia and that contrary to popular belief medicine can sometimes regress ... This is what we see now regretting the virtual absence of experts and good diagnostics cyclotymie and bipolarity attenuated.


Dr. Kahn of the Salpetriere hospital pays tribute to the true discoverers of cyclothymia, German psychiatrists Kahlbaum Hecker and at the end of XIX century. The title that appears on the cover of the book entitled: The Cyclothymia

Forming cyclothymic and its manifestations
(Depression and intermittent stimulation).

Gaston Deny, the master of Peter Kahn, wrote the preface in which he writes: "the existence of a special constitutional psychopathic bedrock for all these pseudo-entities, predating their emergence to their disappearance and surviving that's the important fact that was definitely highlighted by the latest summary of Professor Kräpelin (...). This constitution is psychopathic designated today as cyclothymia

(...). A little further It adds:

"cyclothymic constitution is essentially characterized in terms of clinical variations and continuous oscillations of affective tone or mood which are expressed by a sense of well-being or malaise, which reacts and sounds turn on all modes of psychic activity.

These oscillations of mood are themselves s pertaining to an emotional and exaggerated impressionability whose root cause not to be sought elsewhere than in a state of imbalance, congenital impaired emotional and physical and moral sensitivity. This state of imbalance that puts emotional topic to thank you of every event, the incident as trivial, may be increased or activated by various physical or moral influences, infectious or toxic (...)".

In his introduction, Pierre Kahn rightly reminds us:

"This constitution, the most often hereditary, is characterized by intermittent attacks or circular débuetent generally at an early age.

Seizures in the same patient can be severe enough to make a real psychosis, cleared enough to go unnoticed and be regarded as mere quirks of humor.

Whatever their degree, they offer the character Joint disorders in the affective sphere constant and integrity of consciousness.

In their degree mitigated these forms were often taken for neurasthenia or hysteria (...)".

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1 - Extract from the doctoral thesis of Dr. Peter Kahn cyclothymia (1909)

Obviously cyclothymia has always existed as other mood disorders ( recounted in the Bible or the texts of Homer), it was described not only by doctors but also by artists and writers (Goethe and Werther and Shakespeare with Hamlet!) but did not describe precisely this hypersensitivity and lability mood.

In 1877, the two major German psychiatrists Kahlbaum Hecker and his disciple are finally named by naming the disorder: cyclothymia. In 1898, Hecker cyclothymia described as "a disease of the circular emotional sensitivity" (Gemuthserkrankung).

principles of psychiatry during the XIX century was based on a physiological and biological and biological. Psychoanalysts have questioned psychiatry and particularly on the origin of heritable mental disorders and nervous and somatic treatments substantially. Peter Kramer in his book Listening to Prozac "says eugenics and Nazi racial theories were discredited approach while humoral medicine Ancient Greek had nothing to do with these pseudo-scientific approaches.

Psychoanalysts believed that dialogue between patient and therapist would be the cure rather than a conventional auscultation ... Freud addressed disorders such as hysteria and depression (neurasthenia) by introspection reliving the emotional crises to Originally supposed to evacuate the course that could worsen the patient's situation.

In the 30s, psychoanalysis became increasingly popular in France, Germany and USA. In the 50s, all key positions in U.S. universities were held by psychiatrists, psychoanalysts, psychiatrists while in Europe were still resistance.

In France, May 68 meant a second wave of influence in psychoanalysis thanks to anti-psychiatry movement hostile to the ECT, the concept of "psychopathology" and that psychiatric hospitals were compared to prisons. In France, medical students have requested that psychoanalysis is in school curricula.

In the late 70s, the creation of the DSM (first edition 1980) in the USA and the success of certain drugs have meant a sharp decline of psychoanalysis.

In 1977, Prof. Akiskal reintroduced the concept of temperament, bipolar spectrum and thus cyclothymia.

In Europe, Professor Angst in Zurich and his team working on the concept of bipolar and bipolar spectrum.

The medical history of cyclothymia is therefore unique because it is a disorder well defined and understood at the end of XIX and reappears a century later!

Psychoanalysts and psychiatrists who deny the existence of bipolarity attenuated (BPII) or cyclothymia seem to ignore the remarkable work of German doctors and french at the time! But what seems most worrisome is inability to diagnose and therefore treat those in need. For many doctors, bipolarity is a fashion and therefore only BP I are really sick.

To support my argument, I propose in my next posts you select a few passages of the doctoral thesis of Peter Kahn defended 1909.Ce remarkable work that I mentioned a few weeks ago deserves our attention and admiration .

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Cyclothymia, an old and recent illness ... An atypical history.

While emotional intelligence is increasingly recognized (Gardner Intelligence personal and emotional for Goleman) and it remains an unparalleled advantage in the art persuasion, a broadening of the concept of intelligence to include knowledge of human beings, intelligence in moral matters is possible. In the words of Howard Gardner in "Intelligence Reframed"
as character, morality can be important-in fact more important than intelligence, but it should not be confused with intelligence?
He believes that no exceptional personalities that were studied examples of intelligence "morals" exception may be Gandhi. Picasso, Eliot, Graham, Freud, Stravinsky, and even by Einstein himself showed the insensitivity entity in many aspects of their personal lives while engaging sometimes for great causes.

Matthieu Ricard has written an excellent book with his father Jean-Francois Revel on Buddhism. He recounts his conversion and the philosophy of the Dalai Lama in "The Monk and the Philosopher" in which he confesses, "Yes I met Igor Stravinsky and other great musicians. So I had the chance to meet many of those who are admired in the West, and to be able to get a sense of wonder: Is this is what I aspire? Do I want to become like them? I felt I stay on my hunger, because despite my admiration, I could not fail to note that the genius shown by these men in a particular area, not accompanied perfections of humankind's most simple, like altruism, kindness, sincerity. "

These human qualities are they incompatible with creativity?

Can we be creative without contemplating himself?

there is inevitably a dark side which leads to selfishness and often megalomania and paranoia though unpleasant, but apparently necessary for creativity .

Psychologists noted that self-centeredness (other than self-interest) declined in humans but not in creative individuals. Similarly, Jean Piaget explains that, in children, "sensorimotor egocentrism is progressively reduced." Indeed, transforming an original idea in a comprehensible form requires a "strong ego."
Howard Gardner noted that the insurance whose creators were approached proof of a form of selfishness, egotism and narcissism. They are absorbed in their projects and it is not uncommon for the pursuit of their objectives leads to act to the detriment of others.

According to psychologist Eysenck, such a mixture of creative ability and insensitivity may have a genetic basis. Narcissism example of Kafka or Martha Graham meant they would not commit emotionally to a certain stage in their life not to halt their creative capacity. The ambiguity of the feelings of the artist is well reflected in the American film released this year "Capote." The desire for fame, selfishness or manipulation but may be compassion and love each other - Spiritual or physical - and hypersensitivity, mix in the same creative person.

We have an interesting document concerning the character of Picasso, this is the book published in 2002 by Marina Picasso, entitled "Picasso, my grandfather." She gave an interview to Barcelona daily La Vanguardia, February 14, 2002 with the title: "We can not be a genius and a good person (" buena persona "). "A cruel genius who destroyed many lives, my grandfather died alone, with a courtyard of courtiers; An artistic genius but also a cruel person who knew not be loved or love "(...)." All the women were finally materials for his art; Because the great artist devotes all his time and energy to his art, and everything is "all": all that remains nothing for the people around him "....
The filmd'Agnès Jaoui in 2004, "Comme une image" is remarkable and if true, it tells the story of Lolita Cassard, twenty years of suffering, for his Father Etienne Cassard is not much interested in her and in general "look the other bit, because he looks a lot himself," as stated in the synopsis.

In one of his last books on multiple intelligences, "Intelligence Reframed, Howard Gardner believes that none of the outstanding individuals he studied were examples of intelligence" morals "exception may be Gandhi. Picasso, Eliot, Graham, Freud, Stravinsky, and even Einstein demonstrated in his view of the moral insensibility in many aspects of their personal lives while engaging sometimes for great causes.

My own analysis follows that of Gardner, although some behaviors may be explained by the misunderstanding of his own suffering or self-therapy by the lust for power and domination of the other ...

Marx believed that trade was essentially a dishonest activity, but nothing prevents an honest merchant (eg the Quakers) release only minimal profits to pay themselves a fair wage. This applies to all trades.

Being ethical is just respect each other.

Vauvenargues said: "We must console themselves for not having the talent, as we comfort of not having large spaces: one can be above one and the other by the heart "