Monday, January 30, 2012

Capitalizing on Silver's Mood Swings, Part 1

"You're an idiot!"
"Well, you're a moron!"
"Who you calling moron, you imbecile?"

Is this dialogue from a Three Stooges episode? Or could it be a heated exchange you might overhear on almost any playground in America, during recess due to a game gone awry? Precisely because of the popularization and public adoption of such terms, they, as well as cretin, ignoramus, and retard, have mostly been curtailed as descriptors. Family caretakers of mentally-disabled members tend to find them denigrating.

In film epics, though, Hollywood has been known to take license with these finer details. 1975's Academy Award winner One Flew Over the Coocoo's Nest, is a case in point. Starring Jack Nicholson and Louise Fletcher, this poignant drama provides some insight as to the stress involved in an "insane asylum." I can understand, in that environment, how frustrating the work could be. With compassion exhausted, one might lash out, making a comment they'd later regret.

So perhaps the screenwriters weren't too far off the mark in perpetuating the use of epithets like retard and mental defectives, hurled by a harried and overworked staff. Although most people nowadays don't hesitate to use synonyms such as crazy, mad, insane, or lunatic in conversation, it might be deemed more politic, within the mental health care field to exercise a bit more restraint to avert their usage.

The DSM-IV is a must-have resource that diagnosticians, from therapists, to counselors, psychologists and pyschiatrists, rely on for making a prognosis of patients troubled by mental issues. It is no longer politically correct to use early Twentieth Century terminology to label patients. Now deemed derogatory, professionals no longer assign labels such as idiot, imbecile, or moron, even though these were once all perfectly acceptable IQ category designations. http://en.wikipedia.org/wiki/Moron_(psychology)

While the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, does rely on designations to classify disorders, the terms seem benign in comparison. I doubt any school yard bullies are going to be taunting smaller kids with such tirades as "Oh, shut yer face, you borderline personality little freak. Stop with the histrionics already." Or, to the friend staring into a mirror attempting to perfect her make-up, "Geez, Ginger... stop already. Someone might think you have Narcissistic Personality Disorder!"

Now let's peek into the office of Dr. Gold. Maude, the receptionist, has been busy, answering the insistent ring of the phone, scheduling appointments, and greeting patients. She just signed in a young lady who appeared quite anxious. Maude gives her a clipboard and asks her to take a seat as she fills out some billing forms. Hearing her name over the intercom, Maude picks up the phone and listens a moment.

"Miss Silver, Doctor will see you now." Silver enters the door held open by Maude, and is guided down a hallway and shown into a spacious, sumptuously-furnished office. "Make yourself comfortable, Doctor will be right with you." As she waits, she glances nervously about the room. The mahogany panelled walls are adorned with numerous awards, certificates, and diplomas.

There are pictures as well, presumably of Dr. Gold. There's one of him, lining up a putt on the green, playing with a foursome of athletes in a celebrity golf tournament. There's another of him sitting on a couch, talking with Oprah Winfrey. A third shows him shaking the hand of President Obama. Some prankster has attached a yellow post it note to the frame, on which is printed in block letters, Sociopathic Omniscience Syndrome, incurable.

"Miss Silver," intones the doctor with sepulchral gravitas, "we're going to ask that you take a simple test, the MMPI, that will measure your responses to some questions. "Why? she asks, "I feel fine." The doctor, maintaining eye contact, responds, "Well, Miss Silver, it's been reported to me by colleagues that you have trouble sleeping, at times you're severely depressed, yet at other times given to emotional outbursts. Frankly, you're confounding your family."

"By completing this Minnesota Multiphasic Personality Inventory, it might help us make a preliminary finding of your condition. I can venture a guess at the results, but I want to confirm my diagnosis." Ninety minutes pass, and then finally Miss Silver is finished. She hands the completed test to the doctor. He glances at it briefly, opens a folder and compares it to an answer sheet, and enters the results into his laptop.

After a moment he looks up. He jots some final notes in a manila binder and responds "Well, Miss Silver, it's as I feared. It appears you have a severe case of Bipolar Disorder, with complications." Miss Silver appears stricken, with a deer-in-the-headlights look of panic. "What does that mean?" she wails. Leaning back in his plush leather chair, the doctor replies, "You're a manic-depressive, young lady. Simply put, you're given to extreme mood swings, and that can have grave consequences.

"I hate to put it so bluntly," he continues, "but it seems that you need to hear the truth." Continuing, he leans forward, as if confiding a secret, and explains "I can prescribe some Lithium, which should have a steadying effect. That way your mood won't oscillate as much between highs and lows. Frankly, though, I think you should warn your family so that they know what to expect and can try to be supportive." Part two follows.


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