“Gachet's diagnosis is at odds with Rey's diagnosis, which was confirmed by Dr. Peyron - both of them considered Vincent's disease to be a form of epilepsy. Since then, many doctors have been interested in Van Gogh's disease. Some believed that it was diffuse meningo-encephalitis, others that it was schizophrenia (this opinion was held, in particular, by Karl Jaspers), others that it was mental degeneration and constitutional psychopathy... And in fact, Van Togh’s madness is not so easy amenable to definition and classification. This madness cannot be considered in isolation from the exceptional (in the most literal sense of the word) personality that Van Gogh was. It is as inextricably linked with it as his genius, and it must be judged at a level where generally accepted concepts largely lose their usual meaning. What determined Van Togh’s talent determined all the circumstances of his life and his illness.” (Perruchot, 1973, p. 307.)
Evidence supporting schizophrenic illness
“Schizothymic predisposition. As a child, no special talent in drawing was noticed. The schizophrenic process began in 1887; even earlier, a gradual increase in introversion and regression to infantile complexes was observed. With the rise of schizophrenia, his painting exhibits strong expressionism and regression, reaching the point of ornamentalism" (Westerman-Hoistijn, 1924.)
“Whoever has read Gauguin’s description of his psychosis is unlikely to have any doubts about schizophrenia” (Winkler, 1949, p. 161.)
“The onset of psychosis was at the end of 1887, the diagnosis was made in the spring of 1888. During Christmas 1888, he suffered from acute psychosis. Since 1888, a change in creative style has been noted. There is no epilepsy, since there are no seizures and no specific personality changes with decreased intelligence. The diagnosis is paroxysmal schizophrenia” (Jaspers, 1926.)
“It is well known that in Arles a crisis broke out in the life of Vincent. Usually biographers associate this with severe overwork, malnutrition, excessive smoking, prolonged exposure to the sun, etc., but every psychiatrist knows that all these facts are not the causes of procedural psychoses... The manifestations of psychosis observed in Vincent in Arles were already different than earlier in Borinage and Holland... His stay in the south led to a change in the biological quality of the process, sluggish schizophrenia acquired a more active and periodic course... Then placed in the Saint-Rémy asylum for the mentally ill, he made several drawings from the window with a picture of the crowd. With schizophrenic foolishness, he screamed: “I am the Holy Spirit, I am in my Mind!” He made the same inscription on the wall of the chamber... A new expressionist style with a tendency towards irrationality, heightened emotional grotesqueness of images, convulsively broken figures, deliberate distortion of the external world in accordance with his experiences was a direct effect of Vincent’s great immersion in painful experiences and detachment from reality. At the same time, this was an expression of the more primitive nature of his creativity. In general, his paintings of recent times are very chaotic, the colors have become rougher, they are no longer complete. internal tension and not so bright, the background of the desert predominates. There is a clear decline in the subtlety of sensations [The paintings created in the hospital] ... were rather strange than distorted, although, obviously, there was a tendency towards stereotyping, ornamentalization, congestion, and loss of mental plasticity. and the integrity of what is depicted, as in the drawings of patients with schizophrenia... Thus, there is most reason to think about the schizophrenic process, which was at first sluggish, and then, from the Arles period, took a course designated as oneiric catatonia.” In Auvers there was a transformation of oneiric attacks into a depressive state. The large polymorphism of symptoms and transformation of syndromes also speaks in favor of schizophrenia.” (Tselibeev, pp. 241-243, 245-246.)
Evidence supporting epileptic disease
“We do not share the opinion that this was typical epilepsy. This assumption is contradicted by the fact that he did not have epileptic seizures: there is no data about this in the medical history records psychiatric hospital St. Remy, nor in his personal descriptions of his illness in letters to his brother Theo. IN modern times Kleist, under the title "Episodische Dummern zustande" described a condition of the disease that is close to epilepsy. Consequently, the epileptoid condition, which so closely coincides in many ways with the picture of his illness, amazingly convinces us of such a diagnosis of Van Gogh's disease... Jaspers, one might say, against his will, was forced to say the following regarding Van Gogh: ".. "During such strong attacks of a psychotic illness, he retained a fully critical attitude towards his surroundings - in schizophrenia - an unusual phenomenon." (Riise, 1927, pp. 141 - 142.)
“According to the records of the hospital in Arles, Van Gogh suffered from a somnambulistic form of epilepsy... Evidence of Van Gogh’s mental state is his “Self-portrait with a cut off ear.” (Bogolepov, 1971, p. 400.)
“Epileptoid psychosis without epileptic seizures. Latent epilepsy." (Doiteau, Leroy, 1928, pp. 124, 128.)
"Episodic twilight states close to epilepsy." (Goldbladt, 1928, pp. 67-68.)
"Temporal lobe epilepsy." (Muller, 1959, p. 418.)
"Yellow and orange colors, very characteristic of visions during the so-called aura - a harbinger of an epileptic seizure, like existing data on the seizures that Van Gogh suffered, indicate epilepsy. However, it was precisely for this disease that many doctors treated him, and without success.” (Filonov, 1990, p. 3.)
Evidence supporting other diseases
"Simultaneous combination of schizophrenia and epilepsy." (Bleuler, 1911, p. 145; Bleuler, 1940, pp. 68-69.)
"Cyclothymic personality with periodic depressions and manias." (Perry, 1947, p. 171)
“...The absence of specific personality changes characteristic of most forms of schizophrenia and epilepsy allows us to cast doubt on these diagnoses. The artist’s work and life, his correspondence say that in in this case, apparently we're talking about about a special periodic psychosis in a disharmonious personality.” (Buyanov, 1989, p. 212.)
“Van Gogh suffered from attacks of manic-depressive psychosis with its characteristic cyclical mood swings... In some of his letters to his brother Theo, Van Gogh wrote that he was oppressed by sharp transitions from creative exaltation to complete mental collapse, inability to work and mortal despair... The assumption of manic-depressive psychosis is also supported by the cyclical surges in the artist’s sexual activity, as evidenced by his own confessions in letters to his brother Theo.” (Filonov, 1990, p. 3.)
"Alcoholism (absinthe abuse) with a hereditary predisposition to epilepsy on the mother's side." (Vinchon, 1924, p. 143.)
[A number of authors are trying to correct the erroneous historical idea that] “...Vincent Van Gogh’s painful condition was determined by the presence of epilepsy combined with insanity. These diseases would have been diagnosed during the artist’s lifetime, but they do not have stable, undeniable criteria. An analysis of personal letters to family and friends written between 1884 and the artist's suicide in 1890 reveals the personality of a fully self-aware man who suffered from severe, incapacitating, recurrent dizziness that was paroxysmal but not seizure-like. The artist considered himself to be suffering from epilepsy due to the written conclusion of Dr. Peyron, a doctor from the St. Remy Asylum (France), where on May 9, 1889, Van Gogh voluntarily imprisoned himself in a hospital for epileptics and the insane. However, the clinical data contained in his letters do not correspond to epilepsy, but to Meniere's disease. [The authors emphasize that at that time Meniere's syndrome (labyrinthine disorder) was not yet well known and was often misdiagnosed as epilepsy.]" (Arenbergudp., 1990, p. 70.)
“Van Gogh’s illness manifested itself in two different aspects: on the one hand, from the moment of his twentieth birthday, bipolar psychosis arose with alternating depressive and manic states, reinforced by a family hereditary predisposition. On the other hand, starting in 1888, there was a twilight state and complete loss of consciousness, accompanied by auditory and visual hallucinations, aggressiveness that reached the point of violent insanity and self-mutilation, depressive mood and feelings of fear, increased suicidal danger and complete clarity of mind - all these are symptoms of partial temporal lobe epilepsy with signs of limbic psychomotor epilepsy.” (Neumeyr, 1997a, p. 401.)
Features of creativity
“Much remains unclear and controversial to this day in the pathography of this severe bionegative personality. It can be assumed that there is a syphilitic provocation of schizo-epileptic psychosis. His feverish creativity is quite comparable to the increased productivity of the brain before the onset of syphilitic brain disease, as was the case with Nietzsche, Maupassant, and Schumann. Van Gogh provides a good example of how a mediocre talent, thanks to psychosis, turned into an internationally recognized genius." (Lange-Eich-baum, Kurth, 1967, p. 373.)
“... Psychosis occurs precisely when the incredibly rapid development of the “new style” begins! [“Schizophrenia does not bring in anything absolutely” new, but seems to meet existing forces halfway. Through its mediation, something arises that meets the original aspirations, but would not have arisen at all without psychosis.” , 1999, p. 209.)
“The peculiar bipolarity, so clearly expressed in the life and psychosis of this remarkable patient, is simultaneously expressed in his artistic creativity. Essentially the style of his works remains the same all the time. Only the sinuous lines are repeated more and more often, giving his paintings a spirit of unbridledness, which reaches its culmination point in his last work, where the upward striving and the inevitability of destruction, fall, and destruction are clearly emphasized. These two movements - the movement of ascent and the movement of fall - form the structural basis of epileptic manifestations, just as two poles form the basis of the epileptoid constitution." (Minkovskaya, 1935, p. 493.)
“Van Gogh painted brilliant paintings in between attacks. And the main secret of his genius was the extraordinary purity of consciousness and the special creative enthusiasm that arose as a result of his illness between attacks. F.M. also wrote about this special state of consciousness. Dostoevsky, who at one time suffered from similar attacks of mysterious mental disorder.” (Kandyba, 1998, pp. 350-351.)
[Letter to brother Theo dated September 10, 1889] “In connection with my illness, I think about many other artists who also suffered; this condition does not interfere with painting, and in this case it is as if there was no illness.” (Van Gogh, 1994, vol. 2, p. 233.)
The abundance of pathographic material with analysis of the facts presented makes any comments by the compiler unnecessary. Discussions regarding Vincent van Gogh's diagnosis may still continue, but no one doubts that his mental disorder influenced both the content of his work and the creative process itself. Moreover, it determined his fate.
Van Gogh became an artist at the age of 27, and died at 37. His productivity was incredible - he could paint several paintings in a day: landscapes, still lifes, portraits. From the notes of his attending physician: “In the intervals between attacks, the patient is completely calm and passionately indulges in painting.”
Illness and death
Reproduction of the painting “Sunflowers” (18888)
Van Gogh was the eldest child in the family and already in childhood his controversial nature- At home the future artist was a wayward and difficult child, and outside the family he was quiet, serious and modest.
In the subsequent years of his life, duality manifested itself - he dreamed of a family hearth and children, considering this “ real life", but devoted himself entirely to art. Obvious seizures mental illness started in recent years life, when Van Gogh had severe attacks of insanity, he reasoned very soberly.
According to the official version, intense work, both physical and mental, and riotous image life - Van Gogh abused absinthe.
The artist died on July 29, 1890. Two days earlier, in Auvers-sur-Oise, he went for a walk with drawing materials. He had a pistol with him, which Van Gogh bought to scare away flocks of birds while working in the open air. It was from this pistol that the artist shot himself in the heart area, after which he independently reached the hospital. 29 hours after being wounded, he died from loss of blood.
It is worth noting that Van Gogh shot himself after his mental crisis seemed to have been overcome. Shortly before his death, he was discharged from the clinic with the conclusion: “Recovered.”
There is a lot of mystery in Van Gogh's mental illness. It is known that during seizures he was visited by nightmarish hallucinations, melancholy and anger; he could eat his paints, rush around the room for hours and freeze in one position for a long time. According to the artist himself, in these moments of confusion he saw images of future paintings.
At a mental health clinic in Arles, he was diagnosed with temporal lobe epilepsy. But doctors had differing opinions about what was happening to the artist. Dr. Felix Rey believed that Van Gogh suffered from epilepsy, and the head of the psychiatric clinic in Saint-Rémy, Dr. Peyron, believed that the artist suffered from acute encephalopathy (brain damage). He included hydrotherapy in the course of treatment - a two-hour stay in the bath twice a week. But hydrotherapy did not alleviate Van Gogh's illness.
At the same time, Dr. Gachet, who observed the artist in Auvers, argued that Van Gogh was affected by long exposure to the sun and the turpentine that he drank while working. But Van Gogh drank turpentine when the attack had already begun to relieve its symptoms.
Epileptic psychosis
Today, the most accurate diagnosis is considered to be epileptic psychosis - this is a rather rare manifestation of the disease, which occurs in 3-5% of patients.
Among Van Gogh's relatives on his mother's side there were epileptics - one of his aunts suffered from epilepsy. The hereditary predisposition might not have manifested itself if not for the constant overstrain of mental and emotional strength, overwork, poor nutrition, alcohol and severe shocks.
Manic-depressive psychosis
Among the doctors’ notes there are the following lines: “His seizures were cyclical, recurring every three months. In hypomanic phases, Van Gogh again began to work from sunrise to sunset, painting rapturously and with inspiration, two or three paintings a day.” Based on these words, many diagnosed the artist’s illness as manic-depressive psychosis.
Symptoms of manic-depressive psychosis include thoughts of suicide, unmotivated good mood, increased motor and speech activity, periods of mania and depressive states.
The reason for the development of psychosis in Van Gogh could be absinthe, which, according to experts, contained an extract of wormwood alpha-thujone. This substance, entering the human body, penetrates the nervous tissue and brain, which leads to disruption of the process of normal inhibition of nerve impulses. As a result, the person experiences seizures, hallucinations, and other signs of psychopathic behavior.
"Epilepsy plus madness"
Van Gogh was considered crazy by Dr. Peyron, a French doctor, who in May 1889 stated: “Van Gogh is an epileptic and a sleepwalker.”
Note that until the 20th century, the diagnosis of epilepsy also meant Meniere's disease.
The discovered letters of Van Gogh show severe attacks of dizziness, typical of the pathology of the auricular labyrinth (inner ear). They were accompanied by nausea, uncontrollable vomiting, tinnitus and alternated with periods during which he was completely healthy.
Meniere's disease
Features of the disease: constant ringing in the head, sometimes subsiding, sometimes intensifying, sometimes accompanied by hearing loss. The disease usually develops between the ages of 30 and 50 years. As a result of the disease, hearing loss may become permanent, and some patients develop deafness.
Reproduction of the painting “Self-portrait with a cut off ear” (1889)
According to one version, the story of the cut off ear (the painting “Self-portrait with a cut off ear”) is a consequence of an unbearable ringing.
Van Gogh syndrome
The diagnosis of “Van Gogh syndrome” is used when a mentally ill person inflicts crippling damage on himself (cutting off a part of the body, extensive incisions) or presents persistent demands to the doctor to perform surgery. This disease occurs in schizophrenia, dysmorphophobia, dysmorphomania, and is caused by the presence of delusions, hallucinations, and impulsive drives.
It is believed that, severely suffering from frequent bouts of dizziness, accompanied by unbearable tinnitus, which drove him into a frenzy, Van Gogh cut off his ear.
However, this story has several versions. According to one of them, Vincent van Gogh's earlobe was cut off by his friend Paul Gauguin. On the night of December 23-24, 1888, Van Gogh had a quarrel between them and, in a fit of rage, Van Gogh attacked Gauguin, who, being a good swordsman, cut off Van Gogh’s left earlobe with a rapier, after which he threw the weapon into the river.
But the main versions of art historians are based on the study of police reports. According to the interrogation report and according to Gauguin, after a quarrel with a friend, Gauguin left home and went to spend the night at a hotel.
Reproduction of the painting " Starry night"(1889)
Frustrated, Van Gogh, left alone, cut off his earlobe with a razor, after which he went to a brothel to show a piece of his ear wrapped in newspaper to a prostitute he knew.
It is this episode from the artist’s life that is considered a sign of mental illness, which led him to suicide.
By the way, some experts argue that an excessive passion for green, red and white paints indicates Van Gogh’s color blindness. The analysis of the painting “Starry Night” led to the emergence of this hypothesis.
In general, researchers agree that great artist suffered from depression, which, combined with ringing in the ears, nervous tension and absinthe abuse, could lead to schizophrenia.
It is believed that Nikolai Gogol, Alexandre Dumas fils, Ernest Hemingway, Albrecht Durer and Sergei Rachmaninov suffered from the same disease.
To put it simply, it is an irresistible desire to perform surgical operations on oneself, for example, to cut off parts of the body or make cuts in an attempt to get rid of a contrived physical defect. Most often, this syndrome manifests itself in schizophrenia, hallucinosis, manic-depressive psychosis and other diseases.
The basis of the disorder is formed by internal attitudes towards self-harm, often combined with dissatisfaction with one’s appearance. Accordingly, persons susceptible to the effects of this syndrome strive in every possible way to get rid of the imaginary deficiency on their own or with the help of competent physical intervention.
Obviously the most famous person, who suffered from this illness, was Vincent Van Gogh, who shocked the public by amputating his own ear and sending it to his beloved. At the same time, there is a version that the artist’s ear was deprived by his friend during one of the quarrels. And another possible confluence of events - Van Gogh could have been under the influence of drugs. However, the scientific community still agrees on the idea that the artist has this deviation.
A similar syndrome also appears in demonstrative self-mutilation, for example, during a performance domestic artist Pavlensky on Red Square.
A milder form, so to speak, is self-harming behavior and auto-aggression. In this case, accessible areas of the body are most often affected: arms, legs, chest and abdomen, and genitals. However, no amputation occurs. The reasons for this behavior include the following:
- Demonstrative behavior
- Depression,
- impulsive behavior
- Loss of self-control
- Inability to respond adequately to stress and failure.
According to statistics, women are more susceptible to auto-aggression, and men are more susceptible to Van Gogh syndrome. Because of what this disorder can it develop? There are many reasons for this:
- Genetic predisposition,
- Social influence,
- Diseases of internal organs,
- Alcohol or drug addiction.
Therapy for the disorder involves first of all treating the disease itself, which caused the development of the syndrome. To reduce the uncontrollable desire to harm oneself, antipsychotics and antidepressants are used. If Van Gogh syndrome is diagnosed, hospitalization is necessary to reduce the risk of damage. It is worth saying that this is always a long and complex process, the effect of which is not guaranteed.
And now some hard facts.
The American artist A. Fielding urgently demanded that doctors perform a trepanation on her in order to be able to look at the world differently. She was so obsessed with the idea of enlightenment that she became obsessed with drilling a hole in her skull. Which is exactly what she did.
At a time when the elven race became one of the phenomena of the gaming industry, many people began to self-mutilate their ears in order to try to achieve their pointed shape, like those of virtual characters.
And finally, the harsh practice of amputating fingers as a political or other protest is now spreading. This practice is most common in eastern countries, influenced by the ancient technique of yumitsume (amputation of part of a finger as punishment for non-compliance with the rules of the mafia community).
The essence of Van Gogh syndrome is the irresistible desire of a mentally ill person to perform operations on himself: to inflict extensive cuts, cut off various parts of the body. The syndrome can be observed in patients with schizophrenia and other mental illnesses. The basis of this disorder is aggressive attitudes aimed at causing injury and causing damage to oneself.
The Life and Death of Van Gogh
Vincent Van Gogh, the world-famous post-impressionist artist, suffered from a mental illness, but modern doctors and historians can only guess what it was. There are several versions: Meniere's (this term did not yet exist, but the symptoms are similar to Van Gogh's behavior) or epileptic psychosis. The latter diagnosis was made to the artist by his attending physician and the latter’s colleague, who worked at the shelter. Perhaps they were talking about the negative consequences of alcohol abuse, namely absinthe.
Van Gogh started creative activity only at the age of 27, and died at 37. He could paint several paintings. The attending physician's notes indicate that, between attacks, Van Gogh was calm and passionately indulged in creative process. He was the eldest child in the family and since childhood he showed a contradictory character: at home he was a rather difficult child, but outside the family he was quiet and modest. This duality continued in adult life.
Van Gogh's suicide
Obvious attacks of mental illness began in the last years of his life. The artist either reasoned very soberly, or fell into complete confusion. According to the official version, intense physical and mental work, as well as a riotous lifestyle, led to death. Vincent Van Gogh, as mentioned earlier, abused absinthe.
In the summer of 1890, the artist went for a walk with materials for creativity. He also had a pistol with him to scare away flocks of birds while working. After finishing painting “Wheatfield with Crows,” Van Gogh shot himself in the heart with this pistol, and then made his way to the hospital on his own. After 29 hours, the artist died from blood loss. Shortly before the incident, he was discharged from a psychiatric clinic, concluding that Van Gogh was completely healthy and the mental crisis had passed.
Ear incident
In 1888, on the night of December 23-24, Van Gogh lost his ear. His friend and colleague Eugene Henri Paul Gauguin told the police that there was a quarrel between them. Gauguin wanted to leave the city, but Van Gogh did not want to part with his friend, he threw a glass of absinthe at the artist and went to spend the night at a nearby inn.
Van Gogh, left alone and in a depressed psychological state, cut off his earlobe with a straight razor. Van Gogh's self-portrait is even dedicated to this event. Then he wrapped the lobe in newspaper and went to brothel to a prostitute he knows to show off his trophy and find solace. At least that's what the artist told the police. Officers found him unconscious the next day.
Other versions
Some believe that Paul Gauguin himself cut off his friend's ear in a fit of anger. He was a good swordsman, so it didn’t cost him anything to pounce on Van Gogh and cut off his left earlobe with a rapier. After this, Gauguin could throw the weapon into the river.
There is a version that the artist injured himself because of the news about the marriage of his brother Theo. According to biographer Martin Bailey, he received the letter on the very day he cut off his ear. Van Gogh's brother enclosed 100 francs with the letter. The biographer notes that Theo was not only a beloved relative for the artist, but also a significant sponsor.
The hospital where the victim was taken was diagnosed with “acute mania.” The notes of Felix Frey, a mental hospital intern who looked after the artist, indicate that Van Gogh cut off not only his earlobe, but his entire ear.
Mental illness
Van Gogh's mental illness is quite mysterious. It is known that during seizures he could eat his paints, rush around the room for hours and freeze in one position for a long time, he was overcome by melancholy and anger, and had terrible hallucinations. The artist said that during the period of darkness he saw images of future paintings. It is possible that Van Gogh first saw the self-portrait during an attack.
At the clinic, he was given another diagnosis - “temporal lobe epilepsy.” True, doctors’ opinions about the artist’s health differed. Felix Rey, for example, believed that Van Gogh had epilepsy, and the head of the clinic was of the opinion that the patient had brain damage - encephalopathy. The artist was prescribed hydrotherapy - staying in a bath for two hours twice a week, but this did not help.
Dr. Gachet, who observed Van Gogh for some time, believed that the patient was negatively affected by prolonged exposure to the heat and the turpentine that the artist drank during his work. But he used turpentine during the attack to relieve the symptoms.
The most common opinion regarding Van Gogh’s mental health today is the diagnosis of “epileptic psychosis.” This is a rare disease that affects only 3-5% of patients. The diagnosis is also supported by the fact that among the artist’s relatives there were epileptics. The predisposition might not have manifested itself if not for hard work, alcohol, stress and poor nutrition.
Van Gogh syndrome
The diagnosis is made when a mentally ill person inflicts self-mutilation. Van Gogh syndrome is self-operation or the patient’s insistence on the doctor to perform surgery. The condition occurs in dysmorphophobia, schizophrenia and body dysmorphomania, as well as some other mental disorders.
Van Gogh syndrome is caused by the presence of hallucinations, impulsive drives, and delusions. The patient is convinced that some part of the body is so ugly that it causes unbearable physical and moral suffering to the owner of the deformity and causes horror among others. The patient finds the only solution to get rid of his imaginary defect in absolutely any way. In this case, there is actually no defect.
It is believed that Van Gogh cut off his own ear, suffering severely from severe migraines, dizziness, pain and tinnitus, which drove him into a frenzy, nervous overstrain. Depression and chronic stress could lead to schizophrenia. Sergei Rachmaninov, Alexandre Dumas son, Nikolai Gogol and Ernest Hemingway suffered from the same pathology.
In modern psychiatry
Van Gogh syndrome is one of the most famous psychopathologies. Mental deviation is associated with an irresistible desire to perform operations on oneself with amputation of body parts or forcing medical personnel to carry out the same manipulations. As a rule, Van Gogh syndrome is not a separate disease, but accompanies another mental disorder. Most often, patients with dysmorphomania and schizophrenia are susceptible to pathology.
The cause of Van Gogh syndrome is auto-aggression and self-harming behavior as a result of depression, demonstrative behavior, various violations of self-control, the inability to withstand stress factors and adequately respond to everyday difficulties. According to statistics, men are more often susceptible to the syndrome, but women are more susceptible to auto-aggressive behavior. Female patients are more likely to inflict cuts and wounds on themselves, while men tend to injure themselves in the genital area.
Provoking factors
The development of Van Gogh syndrome can be influenced by a number of factors: genetic predisposition, drug and alcohol addiction, various diseases of internal organs, socio-psychological aspects. The genetic factor has a major influence. According to contemporaries, Van Gogh's sisters suffered from mental retardation and schizophrenia, and his aunt suffered from epilepsy.
The level of personal control decreases under the influence of alcoholic beverages and drugs. If the patient is prone to auto-aggressive behavior, then a decrease in self-control and volitional qualities can lead to serious injuries. The consequences of Van Gogh syndrome in this case are dire - a person may lose too much blood and die.
Social and psychological influence plays an important role. Most often, the patient hurts himself due to the inability to cope with everyday stress, stress, and conflicts. Patients often claim that in this way they replace mental pain with physical pain.
In some cases, the desire to perform surgery on your own is caused by the severe course of a disease. A man who suffers mental disorder and constantly experiencing pain, are more likely to self-mutilate to get rid of the discomfort. It was stated above that Van Gogh’s amputation was an attempt by the artist to get rid of insurmountable pain and constant tinnitus.
Treatment of the syndrome
Treatment for Van Gogh syndrome involves identifying the underlying mental illness or the causes of the obsessive desire to self-mutilate. To relieve obsessive desire, antipsychotics, antidepressants and tranquilizers are used. Hospitalization is required. For Van Gogh syndrome, schizophrenia or other mental illness, this will help reduce the risk of damage.
Psychotherapy will be effective only if the syndrome manifests itself against the background of neurosis or depressive disorder. Cognitive-behavioral psychotherapy is more effective, which will establish not only the reasons for the patient’s behavior, but also appropriate ways to counter outbursts of aggression. The recovery process for Van Gogh syndrome with body dysmorphomania and the dominance of auto-aggressive attitudes is hampered because the patient is not able to achieve positive results.
Treatment is long and does not always end in success. Therapy may generally reach a dead end if the patient has a persistent state of delirium.
Writer and psychiatrist Maxim Malyavin talks about those who constantly want to cut off something for themselves, and not just their ear.
What is Van Gogh syndrome? This is the infliction of crippling damage on oneself by a mentally ill person (cutting off parts of the body, extensive incisions) or the presentation of persistent demands to the doctor to perform surgical intervention on the patient, which is due to the presence of hypochondriacal delusions, hallucinations, impulsive desires
The story from which this syndrome takes its name happened a long time ago. So long ago that only an experienced necromancer can verify it, and we have to be content with versions and guesses. Vincent Van Gogh, Dutch artist XIX century, suffered from chronic mental illness. Which one is also anyone's guess: according to one version, he had schizophrenia, according to another, more probable, based on the opinion of most psychiatrists, - epileptic psychosis (this is the diagnosis that Van Gogh was given by his doctor Ray and his colleague Dr. Peyron in the asylum Saint-Rémy-de-Provence), according to the third version, it was about the harmful consequences of absinthe abuse, according to the fourth - about Meniere's disease.
One way or another, on the night of December 23-24, 1888, Van Gogh lost his earlobe. As his friend and fellow artist Eugene Henri Paul Gauguin told the police, there was a quarrel between him and Van Gogh: Gauguin was about to leave Arles, Van Gogh did not want to part, they quarreled, Van Gogh threw a glass of absinthe at his friend. Gauguin went to spend the night at a nearby hotel, and Van Gogh, left at home alone and in the most deplorable state of mind, cut off his earlobe with a straight razor.
Then he wrapped it in newspaper and went to a brothel, to a familiar prostitute, to show the trophy and seek consolation. At least that's what he told the police.
The artist’s life was cut short by a pistol shot. Having finished painting “Wheat Field with Crows,” on July 27, 1890, Van Gogh shot himself in the chest, and 29 hours later he was dead.
Why do patients with Van Gogh syndrome purposefully and persistently harm themselves? There are several reasons. First of all, this is dysmorphomanic delirium. That is, a firm conviction that one’s own body or some part of it is so ugly that it causes disgust and horror in others, and that the owner of this ugliness is subjected to unbearable moral and physical suffering. And the patient considers the only logical correct decision to get rid of the defect in any way: destroy, cut off, amputate, cauterize, make plastic surgery. And this despite the fact that in fact there is no trace of any defect or deformity.
Hypochondriacal delusions can lead to similar conclusions and consequences. It seems to the patient that some organ, part of the body, or the entire body is seriously (perhaps even fatally or incurably) ill. And a person really feels how exactly it all hurts, and these sensations are painful, unbearable, and you want to get rid of them at any cost.
Impulsive drives, as the name suggests, are in the nature of a sudden push: it’s necessary, period! Neither criticism nor counter-arguments simply have time to connect, the person simply jumps up and acts. Chick - and you're done.
Hallucinations, especially imperative (that is, commanding), can force the patient to deprive himself of a part of the body, inflict on himself deep wounds, beat yourself, or even come up with some more sophisticated self-torture,
Maxim Malyavin, psychiatrist.
I would like to give an example of Van Gogh syndrome from my practice. There is a guy on my site named... let's say, Alexander. It has been observed for quite a long time, about ten years. Schizophrenia. The symptoms have been the same for many years: paranoid (that is, hallucinations and delusions) with suicidal and self-harm tendencies and repeated attempts to injure themselves, commit suicide, with virtually no criticism of their aspirations and experiences, with a paltry and short-lived effect from drug treatment. With all this, calm, quiet, always polite, correct - well, just a good boy. He distinguished himself several years ago. I ended up in the hospital after another such attempt - it seems that I swallowed azaleptin. Then I underwent a course of treatment, things were already getting better - at least that’s what it seemed to everyone.
Shortly before discharge, he was sent home on medical leave; again, it was Easter. Sasha returned from vacation late and accompanied by his mother, with a discharge note from the surgeon in his hands. It turns out that at home the patient locked himself in the bathroom and, using NAIL scissors, opened his scrotum and removed his testicle. Coming out of the bathroom, he asked his mother:
Did I do everything right?
The wound healed quite quickly. The second testicle was also soon removed in the same way. Then there were more suicide attempts, hospitalizations, persistent treatment without hope of effect...
Recently, Alexander came to the hospital to give himself up:
“Otherwise I’ll do something to myself again, and I’m already tired of fighting with her.”
- With whom?
- Well, with HER. Don't you understand? Who am I doing everything for? For her. She asked to cut it off - I cut it off. She asked me to jump from a height - I jumped (it happened, it took a long time for the bones to knit together). I do everything as SHE asks, but she doesn’t come to me.
Having never found out from Alexander the name of the beautiful and dangerous stranger who had been tormenting him for so many years with promises of unearthly bliss in exchange for inhuman suffering, I sat down to write a referral to the hospital.
How to treat the syndrome? First of all, it is necessary to establish which disease caused it in this particular case. And all efforts should be directed towards her treatment and subsequent rehabilitation.
