Three years of high school Latin has left me with an enduring fondness for the language and its pithy sayings. I remain eccentrically pleasured by Latin phrases that crop up in academic writing: e.g. (exempli gratia – for example); inter alia (among other things); vide supra (see above); vide infra (see below); and pace this or that (with all due respect to).

“Pace” is supposed to convey one’s cordial disagreement with a colleague. In this time of vanishing tenure, however, it’s often wielded like a scimitar. Thus, in certain quarters, “pace Dr. Greenberg’s critique of ‘Girls’…” might really mean – “Greenberg’s a doddering antique, his writing stinks, his conclusions are moronic, read my book!” One encounters such mean-spirited competitiveness in academia, as the saying goes, because the stakes are so small. But farewell that.

My favorite academic Latinism is “passim – inter alia”: “here and there” or “in passing.” I was just sitting around and could think of no major subject warranting the full monty, so I went into passim mode.

Bales Redux

I previously cited the disastrous state of military psychiatry in connection with the alleged murder of 17 Afghani civilians by Sgt. Robert Bales.

The news blackout about the case continues in the context of an Article 32 investigation, the Army’s equivalent of a grand jury hearing.

With a problematic history of physical and emotional trauma, Sgt. Bales was nevertheless reassigned to combat duty in Afghanistan. Where, or indeed if, he underwent the Army’s standardized neuropsychiatric evaluation for posttraumatic stress disorder (PTSD) remains a vexed question. He very well may have been examined at the major PTSD diagnostic/treatment center at Madigan Army Medical Center, part of the Joint Base Lewis-McChord military complex near Tacoma, Wash.

Even before the Bales’ debacle, the Madigan program was under scrutiny for allegedly rediagnosing PTSD to adjustment disorder with the obnoxious purpose of bringing various units up to redeployment figures and, even more repugnantly, for refusing to diagnose PTSD in aid of saving the government future pension outlays. Serious questions were also raised about the reliability of the Army’s PTSD evaluation protocol as well as the dismal quality of PTSD therapy, not just at Madigan, but throughout the service.

The New York Times reported on May 16 that the Army is undertaking a general review of psychiatric disability evaluations, as a result of pressure from Sen. Patty Murray (D-Wash.) and other lawmakers. The investigation is to “include a statistical analysis by the Army surgeon general’s office of diagnoses of soldiers who went through the system from Oct. 7 through April 30,” presumably in 2011-2012. The Times further stated that 100 of the nearly 300 soldiers whose disability diagnosis of PTSD was reversed by the Madigan doctors have already had their original determination reinstated.

Two cheers for this news, on several scores. The Latin tag goes: Quis custodiet ipsos custodios? (Who watches the watchers?) No mention is made of civilian researchers, psychiatrists, statisticians being brought in to help design the study or evaluate its outcome.

Why does the study cover only 6 months of a prolonged war that, from its inception, has generated an unholy number of combatants dead by their own hands or reduced to so much psychological wreckage? The numbers of both may just wind up being the largest in American history. And there’s been no inquiry into the foul practice of downgrading PTSD diagnoses to bring units up to redeployment strength.

Worst of all, the Army so far has been unwilling or unable to scrutinize its grossly defective PTSD evaluation protocol, under which traumatized soldiers have been allowed to slip through the cracks. Whether willingly or unwillingly sent back to combat duty, some of these soldiers inevitably will wreak havoc on themselves, their fellows, or noncombatants. (I stress that no such judgment can be rendered vis-à-vis the Bales case at this time, given the lack of solid intel.)

Once more, J’accuse! For all the brave words spouted by military and government authorities about supporting our brave men and women in the field, there’s still an appalling inability to acknowledge, yet alone correct, the persistently wretched psychiatric treatment of PTSD victims while they serve or after their discharge. We civilians are merely being nickle-and-dimed to economic death by the titanic expenses of two ill-conducted wars. Soldiers devastated by PTSD are actually dying or being consigned to living psychological death by the shameful failure in high quarters to dress their wounds.

Curmudgeon Corner

I don’t eat movie popcorn because it’s usually tasteless straw, but I recently arrived at an afternoon showing of “The Avengers” lunch-bereft after an unexpectedly crowded day, so joined the concession line. The summons came: “Would the next guest please step forward?” Guest? Guest?? Well, OK. I dutifully stepped forward, ordered a medium corn and coke.

Chirpy “host”: That will be a gazillion dollars, sir. (Not really, but on that order.)

Dr. G: I thought I was your guest.

CH: You are, sir.

Dr. G: Well, why do I have to pay?

CH: I don’t quite get you, sir.

Dr. G: Well, when I invite people to dinner at my home, I don’t charge them. I won’t even let them split Chinese takeout. Because they are my guests. You don’t charge guests.

CH: Sir, when you stay at a hotel, you are the hotel’s guest. And they do charge!

Dr. G: Not for the soap. Or the shampoo. Or the crappy in-room coffee. Or the wafer-thin mint. Because I am their guest.

CH: But you aren’t sleeping with us, sir. You’re seeing a movie.

Dr. G: That depends on the movie.

Of course, this conversation only occurred in my head. I forked over the ultrabucks, then took in “The Avengers,” which, unfortunately, was too noisy to sleep through.

Since then, I’ve encountered the “guest” thing at several restaurants. They charged me, too. I also was my local bank’s “guest” last week.

They gave me my money, in exchange for their check. Not a toaster in sight.

Apparently, “guest” has been circulating for awhile. I’m not up on the latest linguistic research on where such constructions originate. Are they invented by public relations hacks, in this case to cushion the humungous popcorn tariff? Or do they arise spontaneously, like lethal viral mutations? Thinking further on the issue brought phrases like “hopefully” and “at the end of the day” to mind. These have a brief place in the sun, then return to bad grammar and style hell from whence they came.

At any rate, when I cook or show a DVD at home, my only guests are Sharon, my wife, and my cat, Elvis. I haven’t asked them to pony up for the grub or entertainment, but I’m sure thinking about it now.

Moving Pictures

That movies might move us to do evil things is a worry old as cinema itself. During the era of silent films, it was greatly feared that films might exert dire effects upon children, women, and immigrants. In the Thirties, “The Public Enemy” and “Little Caesar” were accused of seducing adolescent boys into putting down their schoolbooks and picking up tommy guns. In our day, “The Matrix” franchise has been repeatedly cited by defense attorneys for causing one or another murderous rampage. No jury to date has bought that bag.

I’ll take the fifth in the endless debate on whether movies incite mayhem. I’m more fascinated when a film not only makes a viewer feel better, but do better. These cases don’t get into the media as a rule, being unlikely to sell papers or airtime, but they do exist, far more often than one imagines.

I’ve been working with a well-to-do woman in her early 70s, a former therapist whose longed-for retirement has grown decisively tedious. She and her historian husband take in every on- and off-Broadway play, Manhattan museum, concert, jazz club, antique show – but, increasingly, “cui bono” (toward what end)? They are seasoned travelers. For some time, they’ve vaguely entertained the notion that a longer stay abroad might cure their mutual doldrums.

Last week, my patient saw “The Best Exotic Marigold Hotel.” The film presents a diverse sextet of economically challenged elderly Brits who have opted to enter a fabulous senior residence in the city of Jaipur, India. The place turns out to be a deteriorated relic of its former Raj glory, run by a starry-eyed, reasonably incompetent young dreamer. After standard Tinseltown trials and tribulations, all but one of the residents reinvent their lives and decide to stay in India.

My client was particularly struck by the estimable Judi Dench’s character, a widow left nearly bankrupt by a husband she loved but hardly knew. Dench finds her place in the Indian sun, including her first job, and a fellow expatriate’s generous affection.

Several days after seeing the film, my patient declared during her session, “If Judi Dench could do it, so can I!” She’s since arranged to spend 3 months in Hyderabad, India, where she’ll volunteer at a clinic for abused women and her spouse will continue writing his study of a small, especially vicious Civil War battle. After that, ¿quién sabe?

Because of my patient’s aha-erlebnis at the 12-plex, I decided to see “The Best Exotic Marigold Hotel.” It’s slim if well-crafted stuff, a cut above “Eat Pray Love,” which was so saccharine as to make my molars sing. But the film did whatever trick needed to be done for the lady – and here’s the point: In and out of the office, I’ve known more people who have made important life changes after viewing mainstream movies than arthouse pictures. In this respect, I give not a tinker’s damn about cinema aesthetics or ideological sophistication. Hollywood, Bollywood, Whateverwood has always been incredibly knowing about which intrapsychic keys to push – and in the matter at hand, just the right ones.

“Pina” – A Film by Wim Wenders

Practitioners of the discipline known as applied psychoanalysis are essentially creatures of the word – fiction, drama, so forth. Hence, our literature rarely addresses nonverbal arts like music, painting, or architecture. Ballet and other dance forms command even less attention.

Contemporary dance, wedded to performance art, has in fact grown increasingly vocal and, at its best, intellectually and psychologically nuanced. Pina (Philippina) Bausch traveled to America from Germany in the 1960s. After training at Juilliard and dancing for several Manhattan companies, she eventually rebelled against what she believed to be the emotional shallowness of American dance.

She returned home, became director of dance for the Wuppertal theatres, and renamed the company the Tanztheater Wuppertal. Drawing upon the somber aesthetic and psychological conventions of 1920-1930s German expressionism, Bausch forged a radical new dance vocabulary. She worked intensely with a small group of carefully chosen performers until her untimely death from cancer in 2009.

Totally rejecting the tedious rigid feminism of the German left, Bausch conducted a searching interrogation of love’s harrowing vicissitudes over several decades. Whether love was straight or gay, youthful or elderly, mattered not a whit: for Bausch, passion was ever ungendered, timeless. Her signature pieces were “Café Muller,” set to Purcell’s “Dido and Aeneas,” in which female dancers with closed eyes stumbled through a labyrinth of chairs and tables to find and lose a lover; and her astonishing reinvention of Stravinsky’s “The Rite of Spring,” in which she had the stage covered with soil. One saw the sweat and smelled the fear evoked by primal erotic desire.

The great German director, Wim Wenders, wanted for years to collaborate with Bausch. Her demise turned his project into an eloquent memorial. “Pina,” lensed in stunning 3D, excerpts “Café Muller,” “The Rites of Spring,” and other works at length. Moving tributes from her dancers, many of whom were with her from the beginning, are threaded throughout the film. Wenders elects to show only a few moments of Bausch herself, augmenting one’s sorrow at her untimely passing; deepening the resonance of her closing, quiet plea: “Tanzt, tanzt sonst sind wir verloren!” “Dance, dance, otherwise, we are lost!”

“Pina” is still being shown at this writing in some major cities. Otherwise, if possible, watch it in forthcoming Blu-ray disc format.

Originally published on Clinical Psychiatry News 

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