Tag Archives: conversion disorder

Conversion Disorder: 8

Conversion disorder can quite readily be framed in terms of “betrayal.”  Most immediately, there is the sense of the betrayal of one’s own body.  Have you ever had one of those annoying eyelash twitching episodes that continue for days on end?  When I try to imagine the frustration of Ms. Sanchez, I recall  such episodes (and then multiply the frustration a thousandfold).  When my eyelash starts twitching, it’s hard for me not to be a Cartesian, a substance dualist.  “My twitching eyelash is bugging the shit out of me. I wish it would stop already!”

In such moments, the distinction between “the subject of enunciation” and “the subject of the statement” becomes fairly clear.  The subject of enunciation is the res cogitans and the subject of the statement res extensa.  This is not quite the distinction between my mind and my body.  As DG put it, the subject of enunciation is the Cogito and the subject of the statement “the union of the soul and the body, or feeling, guaranteed in a complex way by the cogito.”  Considering Cartesianism as a postsignifying phenomenon, DG conceive the necessary “double betrayal” as taking place between the Cogito and a possibly deceitful God or evil genius.  The “absolute deterritorialization” of the Cogito is thus fueled by its “methodical doubt” in the reality of the outside world.

Insofar as “the union of soul and body” is distinct from the “I think,” it too belongs to the doubtable external world.  The “I think” can never be sure it’s not just a brain in a vat or thing plugged into the Matrix.  In conversion disorder, the primary betrayal must be assigned to the body-soul.  But it’s not only a betrayal, it’s a usurpation!  As Althusser pointed out in his ISA essay (which DG refer to in their treatment of subjectification), the term “subject” has always had two senses: the sense of sovereignity and the sense of servitude.  We could also put this in terms of action and passion.  A subject in the first sense is that which acts autonomously and a subject in the second sense is that which is helplessly acted upon.  In normal circumstances, the Cogito considers itself sovereign over its body-soul; it considers the latter to be its subject.  “Here, do this.  Now, go over there.  Embarrass yourself in the following manner…”  But in eye-twitching and conversion disorder, the Cogito finds itself subjected to its subject.  It finds itself betrayed and rendered utterly passive.  And how easily the betrayal takes place!  And how helpless the Cogito is to do anything about it!  All it can do is wait until the body-soul grows weary of its autonomy and resumes its previous quietude.

Consciousness, stratified by subjectification at least, is already a couple.  And as a couple, it takes for granted Masoch’s law that one of its components must serve as anvil to the other’s hammer.

Scanning several of the interviews Ms. Sanchez gave, I noted the following.  When the interview took place at her home, she always led the interviewer over to a wall that displayed some paintings that I can only assume are her own.  (“I was in art class.  I was in two art classes!”)  One can quickly grasp the significance of this repeated gesture.  Look, that was me then, and this is me now.  On the surface, the temporal division between a past plenitude and a present deprivation is clear-cut.  But when she looks at those paintings, does she see in them signs of the later betrayal?

At least in the interviews, she refuses the diagnosis of conversion disorder.  She did not betray herself.  Something else did: some as yet unidentified pathogen, some biological or environmental agent.  And insofar as the neurologists treating her insist otherwise, they are betraying her too.  She has become absolutely deterritorialized.  But the line remains a negative one.  How to tilt it toward the BwO is the therapeutic question the schizoanalyst must ask.

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Conversion Disorder: 7

Last entry I suggested that from a schizoanalytic perspective “conversion disorder” would refer to the conversion of a body into a particular organism or a concrete individual into a particular subject.  In this sense, conversion means “stratification,” or the process by which unformed matter is captured and “condensed” into formed substances.  There is another sense a schizoanalyst could lend to “conversion disorder”: that is, the conversion of an ideational delusion into an active delusion, the conversion of signifiance into subjectification.  Here “conversion” means “translation,” and refers to the capacity of one semiotic to overcode or exapt the expressions of another.

An example.  In the “regime of signs” plateau, DG state that the ancient Israelites exemplify the workings of the postsignifying regime and the procedure of subjectification.  The point of subjectification is rather more complex than DG explicitly state, so let me try to lard their sketch.  First there is a “double betrayal” on the human scale: the Egyptians betray the Israelities (i.e. betray their original hospitality in the time of Joseph and his brothers) and then the Israelites betray the Egyptians back (insofar as a slave revolt can be considered a betrayal!). The exodus from Egypt amounts to an absolute deterritorialization.  DG portray this “double turning away” in terms of signifiance and subjectification: the “interpretational and paranoid delusion” of the Pharoah against the “most passional and least interpretive delusion” of Moses…

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Conversion Disorder: 5

It’s become difficult to proceed.  And yet I’m only now broaching the subject that kinda got this ball rolling in the first place.  When I first read about this outbreak, it became apparent to me that the largely unspoken and largely ignored presupposition with respect to the idea of conversion disorder is that the psyche is inherently mimetic.  In conversion disorder, or Mass Hysteria, or Mass Psychogenic Illness, psychological distress is said to be “converted” into physical effects.  But the physical effects are not generated from within the psyche; they are picked up or introjected from without.  They are translations of external signs.  Hence one astute researcher thought that the phenomenon should be called MSI, or, “Mass Sociogenic Illness.”  The name MSI has the benefit of alluding to the external origin of the physical effects through which the psyche expresses its distress.  But again, even with this name, the presupposition of a mimetic component has largely gone unthought or unelaborated (at least in the admittedly few articles I’ve now read, and certainly in all of the public statements made by professionals in this particular case).

As soon as I made the connection between conversion disorder and mimesis, I thought of DG’s idea of the postsignifying regime of signs.  I thought of this semiotic because of one terse, suggestive assertion they make about it: the assertion that all transformations taking a given semiotic into the postsignifying regime may be called “consciousness-related or mimetic.” The question then sprang up: could DG’s idea of the postsignifying regime of signs help explain something like conversion disorder?  My hunch was that yes it could.  But the hunch needs to be put to the test, and here is where I get a little diffident.  Because I feel I still don’t have a clear grasp on all the components of the idea, and on their relation with each other and with the idea of mimesis.  But let me set down a list in a somewhat contingent order, so I can have some points from which to proceed.

Components of the postsignifying regime of signs

1. Subjectification.  As “signifiance” was the effect of the signifying regime of signs, so “subjectification” is the effect of the postsignifying regime of signs.  As DG say, the postsignifying regime of signs is defined by the “unique procedure” of subjectification.

2. Subjectification as active delusion.  The signifying regime gives rise to “ideational delusions,” such as the paranoia of Imlac’s astronomer friend in Samuel Johnson’s Rasselas.  “Given that it started raining the moment my despair broke open to a new level, I must unconsciously control the weather.”  But subjectification corresponds to active delusions: monomaniacal delusions, delusions of querulousness, delusions of grievances, passional delusions and erotomanias.  Subjectifications are defined more by “decisive external occurrences,” and are expressed “more as emotions than as ideas, more by actions than by imaginings.”

3. Segmentarity of subjectification.  Subjectification proceeds in linear, temporal segments.  One must end before another can begin.

3. The point of subjectification.  The decisive external occurrence.  The origin of the procedure.

4. The subject of enunciation. Subjectification is the production of a subject.  But a subject is double.  The subject of enunciation first issues from the point of subjectification, “as a function of a mental reality determined by that point.”

5. The subject of the statement.  The subject of the statement issues from the subject of enunciation.  It is “bound to statements in conformity with a dominant reality (of which the mental reality is a part, even when it seems to oppose it).”

6.  The relation between subjects of enunciation and statement.  The former is said to “recoil” into the latter, to the point that the latter resupplies the former for another proceeding or another segment.

7. The regime has two axes.  The syntagmatic axis is that of “consciousness.”  The paradigmatic axis is that of “passion.”

8. The doubling of consciousness.  Consciouness is doubled in the split between the subject of enunciation and subject of statement.  “The cogito is a passion for the self alone.”

9. The fusion of passion.  There is an erasure of the distinction between subject and object, lover and beloved, hater and behated.  “Passional love is a cogito built for two.”  If consciousness makes a couple of itself, passion makes a single virtual subject of a couple.

10. Subjectification as stratum.  Like signifiance, subjectification is a procedure that stratifies us.  Stratification is not all bad, nor is it entirely avoidable.  It is bad to the degree that it renders us powerless and joyless, that it prevents us from discovering what our bodies can do, what we can do with our bodies, what we can make of them, what new relations we can enter into that will enable us to realize our powers and our joys.

11. The other side of the postsignifying regime of signs. We have to keep in mind that the semiotic is tied to an assemblage or formalized mixture of real bodies.  This is the “dominant reality” spoken of above in (5).

There may be more components, but this is more than enough to get the head swimming.  If I can make it back to shore, I might be able to use the idea to complete my pragmatic reading of conversion disorder…


Conversion Disorder: 4

Deleuze and Guattari associate the “signifying regime” (and the “signifiance” that it effectuates) with what psychiatrists of the late-19th century called “ideational delusion.”  The exemplary form of ideational delusion is paranoia.  And what else can one be but paranoid caught up in a potentially infinite number of infinitely circular networks of signs?  Everything is a sign of a sign of my sweet old etcetera.

So we were told that the signifying regime constitutes infinite networks of signs that bend back on themselves and link up with other such networks to form circles within circles and chains of chains.  We were also told that within every such network is a signifier that stands as an “interpretation” (or “point de capiton”) that lends the network an organization, but also fuels its extension in an inhuman chattering without inherent limit of magnitude.  Interpretation: “Obama is a secret communist bent on instituting totalitarianism in America…” Take it away, Fox News!  “Well, the signs are everywhere: look at his contraception policy, or his yadayada yacketyack…”

There are two other important features to the signifying regime. The first is that this semiotic always refers to a pragmatic content or substance.  This substance is a “Face.”  In the signifying regime, the face stands at the center of the swirling networks of signs, as the mask of absolute meaning.  “When I passed by, they looked at me funny and I heard them laugh. Was that about me?  Do they know what I did last summer?  Did they hear about that naked picture I accidentally tweeted?”  DG insist on the inextricable entanglement of a regime of signs with a regime of bodies: expression and content are the two sides of a stratum. The face that besets the paranoiac gripped in her ideational delusion is always the face of a despot.  It is the face that gets off by withholding the absolute meaning it so chastely contains.  It is the face as a white wall upon which signifiance may tirelessly inscribe its signs of signs.

Thera Sanchez insists that before her affliction, everybody was happy to be around her.  She was a cheerleader; she cheered every day.  She was in art class.  She was in two art classes!  Before it happened, everything was fine, she was on a roll… Really?  She was perfectly content?  This seems a bit hard for me to believe.  High school can quite easily take on hellish dimensions even for the popular kids.  High school ably exemplifies the stratum of signifiance, where every face is a potential despot, ready to pass judgment, where every face receives and emits signs of signs of drama to the nth degree, where everyone is chasing the dragon of meaning from one sign to the next, where everyone struggles to occupy the place of the despot or of the interpreting priest.

The face of the despot is always accompanied by a double: the faceless body of the one who is judged, condemned, excluded.  This is the other feature of the signifying regime: the necessity of a scape-goat, of one who is loaded with “everything that resisted signifying signs, everything that eluded the referral from sign to sign through the different circles.”  The scape-goat is sent off into the desert, sent scrambling down a line of flight.  Thera Sanchez is taken out of school.  The scapegoat’s departure ensures the stratum of signifiance will not collapse or explode.  It is therefore a kind of venting mechanism.  The stratum of signifiance only allows for a relative deterritorialization of signs and of bodies.  The expulsion of the scapegoat thus prevents the absolute deterritorialization that would otherwise explode it.  But if its expulsion frees the scapegoat from the despotism of signifiance, introducing it to an absolute deterritorialization, something else is waiting for it out in the desert.  The black hole of subjectification, the postsignifying regime of signs…


Conversion Disorder: 3

The “outbreak” brings into focus (for me, at least) what Deleuze and Guattari called “strata” in A Thousand Plateaus.  According to the duo’s account, there are many different kinds of “strata,” physical, chemical, organic, alloplastic.  But they cite three as especially important to consider: the organism, signifiance and subjectification.

The “organism” is a body organized (or “formalized”) in a particular way.  Signifiance and subjectification refer to specific organizations of linguistic signs into formal “regimes.”  As I understand it, signifiance is the primary effect of a regime of signs that DG refer to as the “signifying regime.”  Subjectification would then be the primary effect of what they call a “postsignifying regime of signs.”

Regimes of signs never exist in isolation, but always in relative mixtures.  If DG spend a great deal of time on these two regimes in particular, it is because the two are the most prominent regimes of our social and political situation.  When I first ran across the story of conversion disorder, I immediately read it in terms of these two strata.  Well, it may be that one could add the third stratum to the mix too, so as to constitute an assemblage in its entirety. The “ticking” organism that has befallen the young girls as the pragmatic “content” to the mixed “expressions” of signifiance and subjectification.  At the same time, it would be necessary to think of this assemblage as a “haeccity,” that is, as a unique and unrepeatable event that has emerged out of a larger one: the Le Roy assemblage as a sign of the subtending assemblage of late capitalist control society?  That’s the tentative hypothesis to be fooled around with for a while until boredom pushes me elsewhere.

Signifiance refers to the infinite deferral of meaning in the perpetual relay from one sign to another.  Signifiance means that “all signs are signs of signs.”  This is the basic structuralist and deconstructionist understanding of language.  (It is important to note that DG refuse the universalization of this understanding: the signifying regime is only one among many that coexist with it or are still to come.)  In any case, signifiance relates that the dragon of meaning perpetually flies down the signifying chain and we perpetually chase after it.  Meaning remains forever incomplete.  In the signifying regime, then, the sign is no longer opposed to a simple referent.  It has become “deterritorialized.”  And in this deterritorialization, the sign has split into two parts: the signifier and the signified.  In attempting to pin down and actualize a “signified,” one moves from signifier to signifier.  This movement bends into a circle: the signs form an infinite network which is infinitely circular.

This network is by no means amorphous.  Why not?  Because something else happens in signifiance: one signifier can stand as the signified, and this signifier then effectuates the organization of the network.  Hence the second aspect of the signifying regime involves interpretation.  But the act of interpreting, the act of selecting a signifier to stand as the signified (Lacan called this special signifier the “point de capiton”) only ensures the continuation of the movement.  “The signified constantly reimparts signifier, recharges it or produces more of it.”

To cut things short.  In the case of the story that concerns us, we see signifiance (or our stratification in signifiance) in the competing interpretations of the event’s significance.  What is the signified of the event that has befallen the girls of Le Roy?  According to the local doctor in charge of the case, and according to the psychiatrist on the Today Show, what the event signifies is “conversion disorder.”  One dissenting doctor has another opinion.  He’s convinced the event signifies “PANDAS” (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections).  What is noteworthy about this latter doctor is the following.  He says that it wouldn’t matter if tests for Streptococcal infections were to come up negative; he’s still convinced it is PANDAS.  In both cases, we have a signifier that functions as a point around which to organize a semiotic network.  And in both cases, the interpretation does little more than allow for the reimpartation of signifying chains.  Put less technically: the interpretations buffer the disease that William Burroughs called “the Yacks.”  The whole event helps bring into focus the stratum of signifiance by virtue of how much chattering it has caused.  The interpretations do not silence the yacks.  They only fuel them further.

On the Today Show, the girl stated that she wanted answers.  That was inaccurate.  For she is getting answers aplenty, but none of them are dissipating the organism that has befallen her.  Indeed she said that she’s grown worse since she started seeing various psychologists and psychiatrists.  What she’s asking for is something different than answers.  She wants to expunge and destroy her ticking organism.  Instead she is being shunted from one circle of hell to the next, from the Today Show to Fox News, etc…


Conversion Disorder: 2

Exiting the manor, I see that my butler is holding open the door of my DG mobile.

–Nietzsche, old chap! How are you this fine morning?

–Can’t complain, sir.  (He turns, shields his mouth with his hand, and vomits a little. Pulls out a handkerchief from his pocket and wipes the ends of his prodigious mustache.)  I beg your pardon.  A bit of a migraine, as usual.  But I’m naturally delighted to be at your service.

–That’s very kind of you.  Tell me, Nietzsche.  What’s with the fake British accent?  You always liked having a laugh at the English.

–Well, I am your projection, sir, and therefore hardly myself.  If I were, I doubt very much we’d have any sort of acquaintance at all.  You’ve a little too much coal in you and not enough diamond.  Still, I can hardly blame you for using me like this.  Whatever exists, having somehow come to be, is again and again reinterpreted to new ends, exapted by a superior power.  And so it is with you and me, sir, or, at least, with you and my name, you and the dead letter of my thoughts.  As they say, the dead lion knows only one thing: that it is better to be a live dog.

–I thought it was better to never have been born.

Nietzsche smiled at this.  Or at least I think he did.  The mustache made it difficult to tell.  Perhaps I merely thought he smiled because his eyes sparkled.  But then his eyes were always sparkling.  I continued.

–Anyway, dear friend, tell me what you think of this phenomenon of conversion disorder.

–What would you like me to say?

–Ha! You always could smell a lure from miles away.  Well, I was thinking about the things you said about the dancing plagues of the Middle Ages.

–Ah, yes the dances of Saints John and Vitus.  I remember.  I had an enduring fascination with those choreomaniacs.

–Would it be fair to say that your fascination with them terminated in ambivalence?

–That would only be fair to say if you consider my writings simultaneously, as a kind of aphoristic constellation. If you consider them in succession, you would have to say that I quite radically reversed my position on them.

–I guess I was thinking in terms of simultaneity rather than succession.  In any case, you explicitly refer to them on two occasions in two very different ways.  Would you care to remind those who are overhearing us what you said in each case?

–God, I hate you.

–Speak, projection.  I promise to release you after this.

–Great, now you think yourself a Prospero.  Vanity works wonders on even the smallest of souls.

–Shut up and speak.

–In my first major public relations disaster, also known as The Birth of Tragedy, I related the John/Vitus dancers to my conception of the Dionysian.  I thought choreomania was a sign of the Dionysian power of de-individuation.  I thought I recognized in these dancers the Bacchic choruses of my beloved Greeks.  I represented the dances as deeds that demolished the barriers that Apollo had set up between individuals.  I represented them as the means by which men were restored to the primordial unity of the world.  I represented the dancers as being seized by the Dionysiac power that produced all of existence in the first place.  I represented them as relinquishing themselves to that power, of having no choice to do so.  I thought that in becoming a marionette of the drunken god a man expressed his sense of belonging to a community prior to and greater than himself.

–Sort of like Marx’s idea of Gattungswesen.

–Don’t try to make me into a socialist.

–You weren’t unequivocally against socialism, dear one.  In fact, in Human

–La la la la.  Don’t change the subject.

–But digressiveness is inherent to philosophy!  And given your idea of masks and caves…

–Yes, yes.  It’s all a rich tapestry.  But let’s not try our readers’ patience any further than what necessity dictates.

–Ha! “Our readers,” right.  Anyway, you spoke of the dancers again, much, much later.  And quite drastically changed your tune.

–That was in your favorite book of mine, The Genealogy of Morals.  I had come to see (or I had written in a way that it appeared that I had come to see) the dances of Saints John and Vitus as signs of another power, the power of the ascetic ideal.

–Talk about a 180.

–Definitely.  I now saw that the dances were the effects not of release or restoration to the primordial unity.  They were the effects of the tremendous repression of the will to power.  The epilectic shudderings of the dancers were signs of degenerating life.  In them, one could see how the ascetic ideal was choking the life out of life.

–It’s strange to think that an ideal can compel, overpower, overmaster, control.

–That’s only if you think of an ideal as a linguistic construction.  What I mean by the ideal is more of a physical or physiological force that subtends the individual.  Like Althusser’s notion of ideology.

–I see.

–How much of a Socratic yes-man you sound!  Is this conversation rigged?  Don’t answer that.

I scoffed.  He continued.

–In any case, while it may seem I changed my mind on the significance of the dancing mania, I at least remained consistent in one sense.

–What sense is that?

–In the sense that I believe the phenomenon arises outside of the individual.  In the sense that the individual is swept up or captured by something that subtends him, and that, as it were, exists prior to him.

–By the way, it’s not cool to exclusively use the masculine pronoun anymore.  Either use the feminine or both or the plural.

–I’m doing it on purpose to piss you off.  Plus it’s in character.

–Fine, I suffer tremendously from white liberal guilt and the shame of being a man.  Now you know.  Do continue.

–I don’t have much more to say.  The important point is that the phenomenon has a collective origin.  If the physicians of your day want to talk about conversion disorder as “psychosomatic,” they should therefore be very careful.  Because they will lead the sufferer to believe that it is all in her head (i.e. her psyche), when it is so clearly not.  I would like to think that a proper therapeutic approach demands an understanding of the origin of the phenomenon outside the “individual mind.”  Isn’t that so, Professor Challenger?

A voice from inside the car issued forth.

–Of course, it is.  By the way, Nietzsche, thanks for last night.

–Always a pleasure, Professor.

Nietzsche gestured gracefully for me to get in.

–Thank you, Nietzsche, I said.  I hope you soon feel better.  When I return, let’s get together again.

–Alas, the world will not have it any other way.

–Hey!

–A joke, sir.  Nothing more.


Conversion Disorder: 1

This morning I ran across the somewhat viral story about the dozen or so high school students in Le Roy NY who have recently come down with a set of symptoms resembling Tourette’s: mainly uncontrollable verbal and physical tics.  It’s disturbing to watch, and disturbing to hear how one of the afflicted relates how she has never felt “more controlled” in her life.  Here’s a piece the Today Show ran on it.

So it seems the physicians directly involved in the case have given the diagnosis of “conversion disorder,” the kinder, gentler re-designation of what used to be called “mass hysteria.”  Probably the most famous of these “outbreaks” (at least the one I was familiar with beforehand) was the Tanganyika laughter epidemic of 1962.  There have been some memorable fictional treatments of conversion disorder too: most recently, Bruce McDonald’s pretty fantastic Pontypool, and, of course, some time back, Luis Bunuel’s sublime Exterminating Angel.

Anyway, let’s entertain for a moment the idea that this outbreak “really is” a manifestation of “conversion disorder,” that is, that there is no biological or environmental cause at play (such as PANDAS).  How can we think about this disorder philosophically?

For physicians, conversion disorder is psychosomatic, meaning, I suppose, that its effects are “somatic” but its cause “psychological.”  What, then, does the disorder say about the psyche?  Well, the idea seems to have at least two presuppositions.  Firstly, it presupposes a depth model of the psyche: that is, a division between conscious and unconscious processes that clearly indicates the relative power of the latter and the relative helplessness of the former.  When the psyche is functioning normally, the conscious ego is largely unaware of the unconscious.  The unconscious is like anything that wields great power: its habit is to remain silent and behind the scenes.  But in conversion disorder, the unconscious starts to talk, if only in signs.  And it lets the ego know in no uncertain terms that it can make it dance to whatever tune it wants.

What else does it say about itself?  Well, it also conveys its mimetic character.  As one of the doctors says in one of the clips, conversion disorder is all about “subconscious mimickry.”  This, then, is the second presupposition: conversion disorder is a disorder of the psyche’s mimetic faculty. So I suppose we are to understand that conversion disorder indicates that stress has weakened the psyche’s resistance to its innate compulsion to imitate…

The idea of conversion disorder as a disorder of the mimetic faculty still doesn’t explain much though, does it?  One of the problems I have with it is that it suggests that there is a “patient zero,” a kind of pacer cell that started the propagation in the first place.  And that just makes me wonder what started her tics?  From the information I’ve gathered, the outbreak makes me think it a phenomenon somewhat like the reconstitution of a slime mold from its individual spores.  In short, conversion disorder seems to be an emergent phenomenon that “captures” its victims in a way that demands we think across the difference between succession and simultaneity, and in a way that demands we resist the impulse to look for a patient zero or pacer cell.

It should come as no surprise that I believe we would profit from thinking “conversion disorder” through a kind of “stratoanalysis.”  Let me elaborate on this further. To the Deleuze-and-Guattari mobile!