A precious case from Middle Earth
BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7480.1435 (Published 16 December 2004) Cite this as: BMJ 2004;329:1435All rapid responses
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Katie says
"Once again, fantasy models real life, as there has been a rarely
mentioned effort to discern the relationships between the intra-psychic
and the inter-psychic. Even in the world of make-believe, eluding to
‘sorcerer-speak’ would naturally result in an honest assessment of
profitable, oppressive, socio-political factors supported by and in
support of eminent financial factors. Clearly, the overwhelming power-over
the individual by these psychosocial factors is based in community
traumatizations that denature individual psyches driving the victims
temporarily dys/nonfunctional, hence subject to and subject of a
psychosocial disability."
Thus the whole "magic" of the mental health system where pills are
some sort of assumed cure (despite that there is NO scientific data
backing it up of stating that mental illness is organic,)
AND
HEH
that's their discipline not mine. Do they really need to try to intrude
into the fantasy-psyche world making this whole "imaginative." parlay (and
I shirk just to even use the word imagination here) creating this
"fictional" world where all your problems are solved with a pill despite
no real scientific data and then call it "science."
How many empty words already? "?"
I don't find that I have the seperation between things implied in the
scientific method myself, I didn't bring it up. I'm not selling pills. I
don't even sell Elixers.
The next step (I'm being a bit sarcastic I think) would be analysing
Sauron, he seems to want the same sort of control the drug companies want
except he's not camoflaging it with saying he's healing people, with him
it's downright power and control......should he be more "secretive" about
it?
In fact I think there's a lot of people who would have a lot to say
about Gollum but would do better to simply look at their own lives because
perhaps they have things going on which are way more ingrained and hidden
and corrupt (without them knowing it.......Healers healing people with
drugs only proven to create chemical imbalances or "illnesses" for
example, or overlooking all of this, or analysing people's behavior in a
social context when they are tortured by powers way beyond the
understanding of such analysers except that perhaps the analysers are
doing part of the torturing)
The psychiatrists have for example analysed and found mentally ill
all sorts of great artists (who are conveniently dead). "If we could have
just helped them."
I don't know what kind of logic this is except if one would build a time
machine and then advertise a performance of Handel's Messiah written while
he was on Lithium)........
Their inability to write a Messiah ofcourse would have nothing to do with
it, that's Handels responsability because he didn't do it their
way........
Also as far as I see it. An attempt to confuse reality with delusion
( healing methods such as drugs that create chemical imbalances, analyses
that torture and alienate those who are being analysed etc.) These are
really failed attempts at accessing the imaginative realm. To get to know
Gollum you would have to have access to these realms. That these realms
have been proven to heal the mind (through art) is more of a given than
any fuss about whether they are real or not!
I think..............
Competing interests:
It would take a certain amount of true imagination
Competing interests: No competing interests
Roelof suggests to us that, “perhaps you should see him (Gollum) for
what he really was for one moment in the book … (not as a creature
existing as the object of all sorts of devised schemes to "socialize" him)
… a very old tired hobbit who knows more about what goes on with such
power struggles then maybe anyone else, and listen (rather than judging
his "social" skills and calling his attempts at trying to express the
anxiety around the ring as "highly developed verbal repertoire" even
though he may act out (live through) the pull that the ring has over him)”
Is this not an apt description of the basis for the supportive,
community help that has been offered, with great success, to individuals
subject to schizophrenia?
As Roelof stated, “This moment was ruined when Samwise became
paranoid and shouted something hostile to Gollum ... the real nature of
what the ring is would only be known to those who have been bearers of the
ring not to staff in an institution bent on analyzing this bond and
devising schemes to change it.“
Since when has confrontation, intimidation and coercion brought out
the best values for any individual?
I find little amusing in the cheery group support responding to
psychiatric analysis of Gollum's "mental illness." Accept for the notable
exception of one (Thank you Roelof.), there is no recognition that we are
discussing an organic illness that has not yet been proven to exist,
anywhere in the universe (See Hitchhiker’s Guide to the Galaxy), except
for the surreal plane of cultural socio-political dictates to the social
norms of behaviour in deference to the profitability of a powerful few.
What has frozen my response (for months) about the Gollum analysis is
the presumptive ease with which mental health professionals devise use of
false assumptions (such as denial of the aforementioned truth reality) to
create artificial analysis, thereby finding fault for behavioural
difference (thought/emotion), by centering their commentary within the
individual (victim-blaming) with little recognition as to fault exterior
to the individual and then only as an aside with little significance
(scape-goating).
Once again, fantasy models real life, as there has been a rarely
mentioned effort to discern the relationships between the intra-psychic
and the inter-psychic. Even in the world of make-believe, eluding to
‘sorcerer-speak’ would naturally result in an honest assessment of
profitable, oppressive, socio-political factors supported by and in
support of eminent financial factors. Clearly, the overwhelming power-over
the individual by these psychosocial factors is based in community
traumatizations that denature individual psyches driving the victims
temporarily dys/nonfunctional, hence subject to and subject of a
psychosocial disability.
Of course, suppressing inherent human expression is the purpose for
which biopsychiatry (psychiatry/behavioural psychology) was created.
Therefore finding fault within the individual is a must needs basic to any
‘hired help’ subjective judgment with mandatory attention to the ‘company
line.’ Unfortunately, the staging of the debate creates an argumentative
'turf' for those of us who are working to enhance the quality of mental
health services. Our purpose is to break the industrial-strength bonding
of mental health services to the exploitation by power--into something
more akin to a humane effort promoting supportive community caring. But to
‘bite into’ the debate is to become as trapped as the victim into a
defensive criticism based on individualism, thereby disabling our
discourse’s effort to achieve holism in community vitality.
Competing interests:
Psychiatric Consumer-Survivor, X-Patient Self-Advocate
Competing interests: No competing interests
From Mr. Edelman's article "Most likely Gollum would have to be
institutionalized. Admittedly this would be difficult these days,
following the movement towards deinstitutionalization."
and also
"Regardless of whatever we tell the insurance company is wrong with
Gollum, something is very wrong with him, he does not behave in a way that
allows him to coexist with others, and he is a danger to himself. More
than coming up with a name for his condition, the priority should be on
fixing his behavioral problems."
So is it implied that we should almost "make something up" and
disregard having integrity towards the insurance company in order to
convince the insurance company Gollum is ill. This actually is how the
mental health system already works. There is no biological basis for
mental illness and the basic supposed "treatment" at asylums is to treat
the illnesses as if they are biological diseases. All this then should be
paid by the insurance company to keep the whole "economy" of the mental
health system going until they find scientific evidence of this supposed
disease they already are treating without any proof that what they are
doing is addressing the biological causes they use as a basis for their
treatment.
this IS what happens in asylums and it also is what happens when
people are forced into incarceration against their will. That is what
"insitutionalization" entails.
There's also this quote:
"While Gollum's ring obsession is superficially like OCD or drug
addiction, the actual contingencies involved in maintaining such behavior
are unknown and would most likely require functional analysis to sort
through. (This would be difficult to do as Gollum has a highly developed
verbal repertoire and would most likely have to be done covertly.) It may
be that various problem behaviors will require that staff interact with
him in very specific ways to make those behaviors less likely and other,
prosocial behaviors more likely. "
I doubt that Gollum would be unaware of these attempts to "covertly"
change his "social" behavior. Especially having been "institutionalized"
which implies also against his will.
As I have already stated there was one place in Tolkien's book where
Gollum almost became himself again and appeared simply as a very old tired
hobbit (not as a creature existing as the object of all sorts of devised
schemes to "socialize" him). This moment was ruined when Samwise became
paranoid and shouted something hostile to Gollum. Gollum at this point was
very close to Frodo and knew what Frodo was going through because Gollum
also had been bearer of the ring for a long time. That also is a personal
relationship between the two and the real nature of what the ring is would
only be known to those who have been bearers of the ring not to staff in
an institution bent on analyzing this bond and devising schemes to change
it. In the end the ring destroys itself when it causes Gollum to take it
from Frodo and then fall to his death where the ring is destroyed, thus
the whole power struggle is over and the ring destroys itself without the
need of all the violence of the wars, I think.
So instead of inviting the whole power struggle (all Sauron's
creatures controlled by the ring for example) into your schemes and
devices of having some method of healing this poor creature perhaps you
should see him for what he really was for one moment in the book, a tired
old hobbit who knows more about what goes one with such power struggles
then maybe anyone else, and listen (rather than judging his "social"
skills and calling his attempts at trying to express the anxiety around
the ring as "highly developed verbal repertoire" even though he may act
out the pull that the ring has over him).
Then instead of a struggle between all the weapons in the world (on
BOTH sides) and one tired old hobbit there might actually be someone who
can help Frodo to actually let go of the ring at the last moment. Someone
who knows because he's been through it.
I thought that's what the story was about.
Also, if there really is a trend towards "deinstitutionalization"
then why are there more people now who have mental illnesses thanks to the
medications? How many institutions do you need? How many TIME'S must the
white dove sail?
Competing interests:
It would take a certain amount of true imagination
Competing interests: No competing interests
Critical Appraisal of ‘A Precious Case from Middle Earth’
The following points need to be made:
1. Smeagol IS a hobbit (also known as Halflings) and not ‘hobbit-
like’. True, the ring of power did alter his external appearance, however
his genotype remains unchanged. Were he to have a DNA test (as seen on
Trisha/Jerry Springer) this would be confirmed.
2. Current Mental Health guidelines would not have advocated 450
years of banishment – under Care in the Community he would probably have
remained in the Shire after appropriate rehabilitation.
3. Smoking ‘Pipe-weed’ may have its benefits over tobacco given that
none of the Shire folk have suffered with the complications seen in
cigarette smokers.
4. Under proposed legislation (as supported by David Dark Lord
Blunkett), an intending thief or burglar may indeed be challenged with
physical force by a person defending his/her property. As such, Gollum had
the right to kill Bilbo Baggins when he committed the now infamous theft
of the ring, or during the battle of wits that followed.
5. Mental State Assessment should be extended to an analysis of the
author’s mental state. Talking trees, giant spiders, rings of invisibility
??? Surely not a sane man.
6. Rather than finding fault in his diet of raw fish and rodents,
this should be applauded. At the age of 587, one would have expected bones
like talcum powder, cataracts like frosted glass, his skin to be one big
wrinkle, teeth for sale as ivory on Ebay, and his mobility to consist of
annually raising an eyebrow. Surprisingly, this low fat high protein diet
rich in Omega 3 fish oils has resulted in freedom from the diseases of old
age.
The mild inconvenience of having scanty scalp hair, a weedy body and
shallow complexion can easily be corrected.
Competing interests:
None declared
Competing interests: No competing interests
Bashir et al have taken a very narrow view on the problems of
Smeagol and
Gollum. After living at the fringes of Middle Earth for 2 decades, I
have a
simple theory for the plight of this innocent person(s).
Smeagol found that there was too much political correctness in Middle
Earth. He was of course, disliked by the hierarchy and rediculed by his
peers.
He left in total disgust to the mountains. The constant diet of fish and
accompanying severe constipation gave him the appearance shown in the
accompanying photograph.
The story about the ring is only a red herring.
Competing interests:
None declared
Competing interests: No competing interests
I have been very amused by all these attempts to diagnose Gollum's
disorder, physical or psychological, and it reminds me of the problem of
diagnosis in general. At least with regard to psychological disorders,
the problems often do not fit into neat little categories. Coming up with
a diagnosis often makes things easy to talk about clusters of
symptoms/features/etc. that frequently go together, not to mention giving
clinicians something ominous-sounding that they can bill an insurance
company for. However, psychological problems often sloppily run into each
other and the boundaries set up are often arbitrary.
Regardless of whatever we tell the insurance company is wrong with
Gollum, something is very wrong with him, he does not behave in a way that
allows him to coexist with others, and he is a danger to himself. More
than coming up with a name for his condition, the priority should be on
fixing his behavioral problems.
So how should we proceed?
Most likely Gollum would have to be institutionalized. Admittedly
this would be difficult these days, following the movement towards
deinstitutionalization. However, it is not likely Gollum would seek
treatment on his own, he has already harmed others, and he is not
adequately caring for himself. Assuming this is done, the various
possibilities of medical problems which so many insightful people have
already mentioned could be done and those issues, if there are any, could
be dealt with.
Let us assume Gollum does not have any serious medical issues or, if
they exist, medical treatment will not eliminate his behavioral problems.
This will be most likely the case. As he has most likely not learned all
the relevant social skills and, living mostly in isolation for hundreds of
years, his behavior has developed in the absence of any social
contingencies, problematic behavior is likely to exist even in the absence
of any medical problems. Even if he is suffering from a condition which
affects behavior, that does not mean his behavior will not be sensitive to
environmental manipulations; behavioral treatments have been demonstrated
successful with disorders where the organic problem is at least partially
known, such as schizophrenia and Alzheimer's.
Speculating on the exact nature of Gollum's problems in behavioral
terms and how they will be treated is tricky (or tricksy), and in the
absence of any actual observations litle can actually be said. Certainly
behavioral skills training (which includes modeling, instruction,
rehearsal, and feedback) could be used to teach more appropriate social
behaviors, but other problems might not be so easy to manage. While
Gollum's ring obsession is superficially like OCD or drug addiction, the
actual contingencies involved in maintaining such behavior are unknown and
would most likely require functional analysis to sort through. (This
would be difficult to do as Gollum has a highly developed verbal
repertoire and would most likely have to be done covertly.) It may be
that various problem behaviors will require that staff interact with him
in very specific ways to make those behaviors less likely and other,
prosocial behaviors more likely. What exactly those will be cannot be
determined on the basis of the information currently availble; they would
be determined based on observations of his behavior and their context, not
a psychiatric diagnosis.
I might also suggest that if Gollum ever were to be released, he
would have to relocate. Just as returning to one's former environment can
cue many addicts to return to drug use, it is not unreasonable to assume
that returning Gollum to his former haunts might send him looking for the
ring again. Perhaps the elves, who are leaving Middle-Earth, might be
able to take him to a more supportive environment.
Competing interests:
The author has long, blond hair, pointy ears, and is immortal.
Competing interests: No competing interests
There is no medical analysis for the creature Gollum. He is merely a
victim of the Ring. When Sauron forged the Ring, he poured his malice,
deceit, and hate in to it. The Ring is not merely a piece of jewelery -
it works to take over its bearer, and it schemes on how to work it's way
back to Mordor and to its master, Sauron. The Ring chose Smeagol as its
bearer instead of Deagol for Smeagol was weaker, and thus easier to
control. All of the Ring's work was for naught, though, when Bilbo
Baggins picked up the Ring and took it back to the Shire, setting in
motion a series of great changes that would include the Ring being taken
very close to its master. These events ended with two Ringbearers
fighting for the possession, and Gollum won, seemingly, by biting off
Frodo's finger, but then falling to his death.
Though the Ring has not the ability to move, it has the power to fill
a person's mind and soul, and tempt them. These may be abstract themes to
you mortals, but I must accept your ideas, for you know not the power of
the the Rings of Power.
Competing interests:
None declared
Competing interests: No competing interests
Smeagol, be careful: a psychiatrist with their behavior actually
might induce a person to hear voices...........and then with what they are
doing now in psychiatry using medications that have only been proven to
create chemical imbalances to turn off "hearing voices".........hearing
voices also when looked at honestly doesn't show that it is necessarily
negative at all, those who have learned to work with the voices in their
head actually attain a whole different level of being able to relate to
others........that already is biased to say that those who are mentally
ill have to have the voices turned off in their head by means that have
only been proven to be destructive (and one would end up validating
chopping their heads off to get the voices to stop were one to follow this
"methodology" through to it's inevitable conclusion it seems to me) all of
this while they have never been given the chance to grow and discover what
is going on with them........
voices, unreal things, illogical not-immediately-understandable
mysteries............
imagination,
this is where you come from Smeagol
and Smeagol don't you let this psychiatrist make you upset and do
aweful things just because he says things about your throat or that
painful things like being in a padded cell are good for you. If you had a
tail, a nice long tail, he might say there was something wrong with that
toooo.........
Competing interests:
It would take a certain amount of true imagination......
Competing interests: No competing interests
okay what about psychopathy?
As I have already stated, when someone shows the type of callous need
to analyse others and state what is wrong with them to glorify their
judgements it becomes logical where the motive of killing might come from.
If you read the whole story you would see that at one point Gollum
almost becomes himself, Tolkien describes how he for that moment (the only
one in the book) looks lie a very old hobbit rather than what he had
become......that whole moment is ruined because Samwise sees him, and
because he is close too Frodo becomes paranoid and harsh and prejudiced
and with his immediate biased response ruins the whole moment and we never
find out what might have happened had Gollum become himself again.......
So next time you decide to analyse someone into being something other
then themselves...take a look at what happens when you instill that kind
of behavior on others............Samwise for example......you DON'T know
what would have happened if Samwise had been compassionate rather than
prejudiced.
Competing interests:
it would take a certain amount of true imagination
Competing interests: No competing interests
Gollum: Tolkien's Hamlet?
I have actually been fascinated by Gollum for long time and this is
not at all driven by any physical resemblance,whatsoever, that I may have
with him.
I think Gollum is a victim of his own success. He has merely heard the
call of the Ring. He is at the same time fortunate and unlucky to have
come in the posession of the Ring. It makes him special and it makes his
ilk jealous,hence,ostracism.
As for the psychosocial underpinnings of his personality, the lack of a
contemporary model is a major road-block to understanding the complex
phenomenon of his personality. As the events are taking place in the
Middle Earth in an antique time, one should be wary of extrapolating
modern sensibilities onto a radically different frame of reference.
Competing interests:
Some physical resemblance to Gollum
Competing interests: No competing interests