Traumatic

Traumatic (pronounced traw-mat-ik (U), truh-mat-ik or trou-mat-ik (both non-U))

(1) In clinical medicine, of, relating to, or produced by a trauma or injury (listed by some dictionaries as dated but still in general use).

(2) In medicine, adapted to the cure of wounds; vulnerary (archaic).

(3) A psychologically painful or disturbing reaction to an event.

1650–1660: From the French traumatique, from the Late Latin traumaticum from traumaticus, from the Ancient Greek τραυματικός (traumatikós) (of or pertaining to wounds, the construct being traumat- (the stem of τραῦμα (traûma) (wound, damage) + -ikos (-ic) (the suffix used to forms adjectives from nouns).  Now familiar in the diagnoses post traumatic stress disorder (PTSD) & post traumatic stress syndrome (PTSS), it was first used in a psychological sense in 1889.  Traumatic is an adjective & noun and traumatically is an adverb; the noun plural is traumatics.

PTSD, PTSS and the DSM

Exposure to trauma has been a part experience which long pre-dates the evolution of humans and has thus always been part of the human condition, the archeological record, literature of many traditions and the medical record all replete with examples, Shakespeare's Henry IV often cited by the profession as one who would fulfill the diagnostic criteria of post traumatic stress disorder (PTSD).  Long understood and discussed under a variety of labels (famously as shell-shock during World War I (1914-1918)), it was in 1980 the American Psychiatric Association (APA) added PTSD to the third edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-III).  The entry was expected but wasn’t at the time without controversy but it’s now part of the diagnostic orthodoxy (though perhaps over-used and even something of a fashionable term among the general population) and the consensus seems to be that PTSD filled a gap in psychiatric theory and practice.  In a sense that acceptance has been revolutionary in that the most significant innovation in 1980 was the criterion the causative agent (the traumatic event) lay outside the individual rather than there being an inherent individual weakness (a traumatic neurosis).

However, in the DSM-III, the bar was set higher than today’s understanding and a traumatic event was conceptualized as something catastrophic which was beyond the usual range of human experience and thus able to be extremely stressful.  The original diagnostic criteria envisaged events such as war, torture, rape, natural disasters explosions, airplane crashes, and automobile accidents as being able to induce PTSD whereas reactions to the habitual vicissitudes of life (relationship breakdowns, rejection, illness, financial losses et) were mere "ordinary stressors" and would be characterized as adjustment disorders.  The inference to draw from the DSM-III clearly was most individuals have the ability to cope with “ordinary stress” and their capacities would be overcome only when confronted by an extraordinarily traumatic stressor.  The DSM-III diagnostic criteria were revised in DSM-III-R (1987), DSM-IV (1994), and DSM-IV-TR (2000), at least partly in response to the emerging evidence that condition is relatively common even in stable societies while in post-conflict regions it needed to be regarded as endemic.  The DSM-IV Diagnostic criteria included a history of exposure to a traumatic event and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms, and hyper-arousal symptoms; also added were the DSM’s usual definitional parameters which stipulated (1) the duration of symptoms and (2) that the symptoms must cause significant distress or functional impairment.

#freckles: Freckles can be a traumatic experience.

The changes in the DSM-5 (2013) reflected the wealth of research and case studies published since 1980, correcting the earlier impression that PTSD could be thought a fear-based anxiety disorder and PTSD ceased to be categorized as an anxiety disorder, instead listed in the new category of Trauma- and Stressor-Related Disorders, the critical definitional point of which is that the onset of every disorder has been preceded by exposure to a traumatic or otherwise adverse environmental event.  It required (1) exposure to a catastrophic event involving actual or threatened death or injury or (2) a threat to the physical integrity of one’s self or others (including sexual violence) or (3) some indirect exposure including learning about the violent or accidental death or perpetration of sexual violence to a loved one (reflecting the understanding in the laws of personal injury tort and concepts such as nervous shock).  Something more remote such as the depiction of events in imagery or description was not considered a traumatic event although the repeated, indirect exposure (typically by first responders to disasters) to gruesome and horrific sight can be considered traumatic.  Another clinically significant change in the DSM-5 was that symptoms must have their onset (or a noticeable exacerbation) associated with the traumatic event.  Sub-types were also created.  No longer an anxiety disorder but now reclassified as a trauma and stressor-related disorder, established was the (1) dissociative sub-type which included individuals who meet the PTSD criteria but also exhibit either depersonalization or derealization (respectively alterations in the perception of one's self and the world) and (2) the pre-school subtype (children of six years and younger) which has fewer symptoms and a less demanding form of interviewing along with lower symptom thresholds to meet full PTSD criteria.

When the revised DSM-5-TR was released early in 2022, despite earlier speculation, the condition referred to as complex posttraumatic stress disorder (CPTSD) wasn’t included as a separate item, the explanation essentially that the existing diagnostic criteria and treatment regimes for PSTD were still appropriate in almost all cases treated by some as CPTSD, the implication presumably that this remains an instance of a spectrum condition.  That didn’t please all clinicians and even before DSM-5-TR was released papers had been published which focused especially on instances of CPTSD be associated with events of childhood (children often having no control over the adverse conditions and experiences of their lives) and there was also the observation that PTSD is still conceptualized as a fear-based disorder, whereas CPTSD is conceptualized as a broader clinical disorder that characterizes the impact of trauma on emotion regulation, identity and interpersonal domains.

Still, the DSM is never a static document and the committee has much to consider.  There is now the notion of post-traumatic stress syndrome (PTSS) which occurs within the thirty-day technical threshold the DSM establishes for PTSD, clinicians noting PTSS often goes unrecognized until a diagnosis of PTSD is made.  There is also the notion of generational trauma said to afflicting children exposed repeatedly to the gloomy future under climate change and inter-generational trauma Screening tools such as the PTSS-14 have proven reliable in identifying people with PTSS who are at risk of developing PTSD. Through early recognition, providers may be able to intervene, thus alleviating or reducing the effects of a traumatic experience.  Long discussed also has been the effect on mental health induced by a disconnection from nature but there was no name for the malaise until Professor Glenn Albrecht (b 1953; one-time Professor of Sustainability at Murdoch University (Western Australia) and now honorary fellow in the School of Geosciences of the University of Sydney) coined psychoterratic, part of his lexicon which includes ecoagnosy (environmental ignorance or indifference to ecology and solastalgia (the psychic pain of climate change and missing a home transforming before one’s eyes).  The committee may find its agenda growing.

Saved by a “traumatic” transmission

In the 1960s, “the ocean was wide and Detroit far away” from Melbourne which is why Holden was authorized to design and built its own V8 rather than follow the more obviously logical approach of manufacturing a version of Chevrolet’s fully-developed small-block V8.  The argument was the Chevrolet unit wouldn’t fit under the hood of Holden's new (HK) range which was sort of true in that there wasn’t room for both engine and all ancillaries like air-conditioning, power brakes and power steering although it would have been easier and cheaper to redesign the ancillaries rather than embark on a whole new engine programme but this was the 1960s and General Motors (GM) was in a position to be indulgent.  As it was, Holden’s V8 wasn’t ready in time for the release of the HK in 1968 so the company was anyway forced in the interim to use 307 cubic inch (5.0 litre) and 327 (5.3) Chevrolet V8s, buyers able to enjoy things like power steering or disk brakes but not both.

The "Tasman Bridge" 1974 Holden Monaro GTS (308 V8 Tri-matic).  The HQ coupé was Holden's finest design. 

Also under development was a new three-speed automatic transmission to replace the legendarily robust but outdated two-speed Powerglide.  It was based on a unit designed by GM’s European operation in Strasbourg and known usually as the Turbo-Hydramatic 180 (TH180; later re-named 3L30-C & 3L30-E) although, despite the name, it lacked the Powerglide-like robustness which made the earlier (1964) Turbo-Hydramatic 400 (TH400) famous.  Holden called its version the Tri-matic (marketed eventually without the hyphen) and, like the early versions of the TH180 used in Europe, there were reliability problems although in Australia things were worse because the six and eight cylinder engines used there subjected the components to higher torque loadings than were typical in Europe when smaller displacment units were used.  Before long, the Tri-matic picked up the nickname “traumatic” and in the darkest days it wasn’t unknown for cars to receive more than one replacement transmission and some even availed themselves of their dealer’s offer to retrofit the faithful Powerglide.  The Tri-matics’s problems were eventually resolved and it became a reliable unit, even behind the 308 cubic inch (5.0 litre) Holden V8 (although no attempt was ever made to mate it with the 350 cubic inch (5.7 litre) Chevrolet V8 Holden offered as an option until 1974).  As a footnote, even today the old Powerglide still has a niche because it's well suited to drag-racing, the single gear change saving precious fractions of a second during ¼ mile (402 metre) sprints.  

Whatever its troubled history, the “traumatic” did on one occasion prove a lifesaver.  In the early evening of 5 January 1975, the bulk carrier Lake Illawarra, while heading up Hobart's Derwent River, collided with the pylons of the Tasman Bridge which caused a 420 foot (128 m) section of the roadway to collapse onto the ship and into the river, killing twelve (seven of the ship's crew and five occupants of the four cars which tumbled 130 feet (40 m) into the water.  Two cars were left dangling precariously at the end of the severed structure and it emerged later that the 1974 Holden Monaro was saved from the edge only because it was fitted with a Tri-matic gearbox.  Because the casing sat lower than that used by the manual gearbox, it dug into to road surface, the frictional effect enough to halt progress.

The tragedy had a strange political coda the next day when, at a press conference in The Hague in the Netherlands, the Australian prime-minister (Gough Whitlam, 1916-2014; Australian prime-minister 1972-1975) was asked about the event and instead of responding with an expression of sympathy answered:

I sent a cable to Mr Reece, the Premier of Tasmania, I suppose twelve hours ago and I received a message of thanks from him.  Now you have the text I think.  I expect there will be an inquiry into how such a ludicrous happening took place.  It's beyond my imagination how any competent person could steer a ship into the pylons of a bridge.  But I have to restrain myself because I would expect the person responsible for such an act would find himself before a criminal jury. There is no possibility of a government guarding against mad or incompetent captains of ships or pilots of aircraft.

Mr Whitlam’s government had at the time been suffering in the polls, the economy was slowing and ten days earlier Cyclone Tracy had devastated the city of Darwin.  The matter didn’t go to trial but a court of marine inquiry found the captain had not handled the ship in a proper and seamanlike manner, ordering his certificate be suspended for six months.

Aftermath:  Hobart clinical psychologist Sabina Lane has for decades treated patients still traumatized by the bridge’s collapse in 1975.  Their condition is gephyrophobia (pronounced jeff-i-ro-fo-bia), from the Ancient Greek γέφυρα (géphura) (bridge) + -phobia (fear of a specific thing; hate, dislike, or repression of a specific thing), from the New Latin, from the Classical Latin, from the Ancient Greek -φοβία (-phobía) and used to form nouns meaning fear of a specific thing (the idea of a hatred came later) which describes those with an intense fear of driving over a bridge (which in the most severe cases can manifest at the mere thought or anticipation of it), sometimes inducing panic attacks.   Ms Lane said she had in the last quarter century treated some seven patients who suffered from gephyrophobia trigged by the trauma associated with the tragedy, their symptoms ranging from “...someone who gets anxious about it all the way to someone who would turn into complete hysterics."  Some, she added, were unable “…even to look at a photo of the Tasman Bridge.”  She noted the collapse remains “still quite clear in everybody's mind, and that's perhaps heightened by the fact that we stop traffic when we have a large boat passing beneath it."  Her treatment regime attempts to break the fear into manageable steps, having patients sketch the bridge or study photographs before approaching the structure and finally driving over it.

Mnemonic

Mnemonic (pronounced ni-mon-ik)

(1) Something assisting or intended to assist the memory.

(2) Pertaining to mnemonics or to memory.

(3) In computing, truncated code thought easy to remember (eg STO for store).

1660–1670: From the New Latin mnemonicus from the Ancient Greek μνημονικός (mnēmonikós) (of memory) derived from μνήμων (mnḗmōn) (remembering, mindful) & μνᾶσθαι (mnâsthai) (to remember); the ultimate root was the primitive Indo-European men (to think).  The meaning "aiding the memory", a back-formation from mnemonics dates from 1753, the noun meaning "mnemonic device" is from 1858.  The use in computer programming emerged in the early days of code and was a space-saving (eg del rather than delete) tool as well.  Mnemonical was the original form from the 1660s.  One of the charming ironies of mnemonic is it is one of those words so many can't quite remember how to spell.  It's thus in a sense "antimnemonic" and a contronym (also as auto-antonym, antagonym, or enantiodrome) which describes a word with two opposite or contradictory meanings, depending on context.  Mnemonic is a noun & adjective, mnemonician, mnemonicalist, mnemotechnist & mnemonicon are nouns, mnemonize & mnemonized are verbs, mnemonical & mnemotechnic are adjectives and mnemonically & mnemotechnically are adverbs; the noun plural is mnemonics.

Sans Forgetica

Sans Forgetica sample text.

Recently released, Sans Forgetica (which translates as "without forgetting") is a sans-serif font developed by RMIT University in Melbourne.  Back-slanted and with gaps in the character constructions, it’s designed explicitly to assist readers better to understand and retain in their memory what they’ve read.  Perhaps counter-intuitively for those outside the field, the shape is intended to reduce legibility, thereby (1) lengthening the tame taken to read the text and (2) adding complexity to learning and absorbing what’s been read.  Together, they create what in cognitive psychology and neuroscience is called "desirable difficulty", in this case forcing (RMIT might prefer "nudging") people to concentrate.

The first three paragraphs of Lindsay Lohan's Wikipedia page, rendered in Sans Forgetica.  Sans was from the Middle English saunz & sans, from the Old French sans, senz & sens, from the Latin sine (without) conflated with absēns (absent, remote).   Forgetica was an opportunistic coining, the construct being forget + -ica.  Forget was from the Middle English forgeten, forgiten, foryeten & forȝiten, from the Old English forġietan (to forget) (which was influenced by the Old Norse geta (to get; to guess), from the Proto-West Germanic fragetan (to give up, forget).  The -ica suffix was from the Latin -ica, the neuter plural of -icus (belonging to derived from; of or pertaining to; connected with).

From usually a young age, readers become skilled at scanning text, a process helped by most publishers seeking to render their works as legible as possible.  The theory of desirable difficulty is that omitting parts of the font requires the reader to pause and process information more slowly, thus provoking an additional cognitive processing which may enhance both understanding and retention.  While the application of the science to a font is novel, there’s nothing original about Sans Forgetica as a piece of typography, it being described as a hybrid of several existing schools and within the theory, on the basis of a small-group sample of students, it’s claimed to be a balance between legibility and difficulty.  According to the documents supplied by the developer, it’s not been tested as a device for advertisers to draw people to their text, the theory of that being people scan and dismiss (without retention) the great bulk of the large, static signage which is a feature of just about every urban environment.  With Sans Forgetica, because it can’t as quickly be scanned, people will tend longer to linger and so more carefully read the whole; a memorable event itself.

The most recent revision (DSM-5-TR (2022)) to the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) followed DSM-5 (2013) in refining the somewhat vague section on amnesia in both the DSM-IV (1994) & DSM-IV-TR (2000) where appeared the terms “Psychogenic amnesia” & “dissociative amnesia”, the core element of which was: “one or more episodes of inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness.”  That really reflected the popular understanding and there was no clear definition of sub-types in the diagnostic criteria although in the text (not always in criteria) there was mention of localized, selective or generalized forms.  In the fifth edition, the disorder was called Dissociative Amnesia (psychogenic amnesia seems to have been replaced) and it was listed in the dissociative disorders section.  The definition still includes an “inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting” so the popular understanding remains acknowledged but sub-types are now listed: localized (for specific event(s)), selective (some parts of the event), or generalized (identity and life history) amnesia.  Consistent with the structural revisions elsewhere in the fifth edition, the exclusion criteria was made more explicit (ie the memory loss should not be due to substances, medication, a neurological condition or better accounted for by another mental disorder) although clinician remain aware of overlap.  Significantly the DSM-5 did clarify that amnesia is retrograde (loss of pre-existing memories), especially of autobiographical kind and emphasised the memory loss is “beyond what is expected from normal forgetting.”  Because in such matters, there will be so much variation between patients, it remains one of those conditions with fuzzy boundaries and the symptoms presented must be assessed on a case-by-case basis.

Amnesia (memory loss) is much studied and although associated with the aging process, traumatic events (brain injury or psychological impacts) and certain neurological conditions, there have been some celebrated cases of recovery without medical intervention.  One celebrated case was that of Rudolf Hess (1894–1987; Nazi Deputy Führer 1933-1941) who in 1941 (on the eve of Germany invading the USSR) flew himself to Scotland in a bizarre and unauthorized attempt to negotiate a peace deal with those in the UK he though would be "reasonable men".    His "offer" was rejected and he was locked up (including two weeks in the Tower of London), later to be sent as a defendant before the IMT (International Military Tribunal) in the first Nuremberg Trial (1945-1946).  There, so convincing were his symptoms of amnesia and other mental states the judges requested submissions from defence and prosecution counsel on the matter of his fitness to stand trial.  The prosecutors assured the bench Hess would be able to both understand and cope with the proceedings and that an imperfect memory was merely a hindrance to his defence rather than an insuperable obstacle.  This was of course a predictable argument and the judges acceded to the defence’s request for a thorough medical investigation although they declined the suggestion Swiss doctors be consulted, assembling instead a team from medical staff on hand (three Soviet, three American, three British and one French), all from the nations running the trial.  The physicians presented four national papers which broadly were in agreement: Hess was sane (as legally defined) but was suffering from hysterical amnesia, induced by his need to escape from uncomfortable realities, something they found was often typical of “those with Hess’s unstable personality”.  All concluded the amnesia was temporary and would vary in intensity, the US doctors suggesting it may even disappear were any threat of punishment removed.

Caricature of Rudolf Hess at the first Nuremberg Trial by New Zealand-born UK cartoonist David Low (1891-1963).

The author Rebecca West (1892–1983) covered the trial as a journalist and wrote some vivid thumbnail sketches, noting of Hess: “Hess was noticeable because he was so plainly mad: so plainly mad that it seemed shameful that he should be tried.  His skin was ashen and he had that odd faculty, peculiar to lunatics, of falling into strained positions which no normal person could maintain for more than a few minutes, and staying fixed in contortion for hours. He had the classless air characteristic of asylum inmates; evidently his distracted personality had torn up all clues to his past.  He looked as if his mind had no surface, as if every part of it had been blasted away except the depth where the nightmares live.”  Whether or not Hess was "mad" (as such folk were described in 1946) can be debated but to many at the time, he certainly looked a madman.

Predictably unconvinced, Hess’s counsel at a hearing on 30 November 1945 told the bench a defendant could hardly stage an adequate defence if unable to remember names or incidents vital to his case, adding that on the basis of discussions with his client, even if he understood the words, Hess was incapable of grasping the significance of the charges against him.  Nor would a trial in absentia be fair because it would constituent a “grave injustice” were a defendant not present to give evidence or challenge the testimony of witnesses.  He concluded by requesting proceedings against him should be suspended and resumed only if his condition significantly improved.  To that, the British countered with a lengthy lecture on the distinctions in English law between amnesia & insanity and seconded the Soviet view that participation in the trial (and thus the need to make a defence) might well cure his condition.  Essentially, the British argued if he could follow the proceedings, he was fit to stand trial.  The US team noted Hess had at times claimed to be suffering amnesia while in captivity in England between 1941-1945 and on other occasions admitted the condition was simulated.  In the slang of the English criminal bar: “He had a bit of previous”.  The Americans also expressed annoyance at him having repeatedly refused any of the treatment prescribed by the Allied doctors, concluding: “He is in the volunteer class with his amnesia”.  The lawyers having finished, the IMT asked Hess if he wished to speak on the matter.  Without delay, he rose in the dock and walked to the microphone where he addressed the court in a clear and calm voice, his statement coherent, unambiguous and, most historians have concluded, clearly premeditated: “Henceforth my memory will again respond to the outside world.  The reasons for simulating loss of memory were of a tactical nature.  Only my ability to concentrate is, in fact, somewhat reduced.  But my capacity to follow the trial, to defend myself, to put questions to witnesses, or to answer questions myself is not affected thereby.  I also simulated loss of memory in consultations with my officially appointed defence counsel. He has therefore represented in good faith.”

He then sat down in what was described as a “stunned courtroom”.  It was at that point the trial’s most sensational moment and after taking a few seconds to digest things, the assembled press pack in their dozens rushed outside to file the story (the US military newspaper Stars and Stripes ran the punchy headline “Hess Nuts. Fake Story Fake”).  Immediately, the president of the IMT adjourned the session and the judges went into private session to decide whether Hess should be tried.  From their subsequent interviews and writings it appears they were not much influenced by Hess’s unexpected statement but were impressed by the similarity of the conclusions offered by the doctors, the chief US prosecutor saying such “unanimity of medical opinion” was, in his experience: “historically unique”.  All eight judges agreed Hess was fit to stand trial and, after being convicted on two counts ((1) conspiracy to wage aggressive war and (2) waging aggressive war), he was handed a life sentence and would remain incarcerated until in 1987 he committed suicide after some 46 years behind bars, the last two decades of which were served as the sole inmate (guarded by dozens of soldiers on rotation from France, the UK, US and USSR) of Berlin’s sprawling Spandau Prison, a huge facility designed to incarcerate hundreds.

Low’s take on the official German line explaining Hess deserting the German government as “madness”.  This cartoon does represent what was then the prevailing public perception of the typical appearance expected of those in “lunatic asylums”.  Depicted (left to right) are:

Hermann Göring (1893–1946; leading Nazi 1922-1945, Hitler's designated successor & Reichsmarschall 1940-1945): Committed suicide by by crushing between his teeth an ampule of a potassium cyanide (KCN), smuggled into his cell in circumstances never confirmed, shortly before he was to be hanged after being convicted on all four counts ((1) Conspiracy to wage aggressive war; (2) Waging aggressive war; (3) War crimes and (4) Crimes against humanity.

Adolf Hitler (1889-1945; Führer (leader) and German head of government 1933-1945 & head of state 1934-1945): With his wife Eva (née Braun; 1912–1945) of a few hours, committed suicide (he by gunshot and KCN, she by KCN alone) with the tanks of the Red Army only a couple of blocks from the Berlin Führerbunker.

Dr Robert Ley (1890–1945; head of the Deutsche Arbeitsfront (German Labour Front) 1933-1945): Before the trial began, he committed suicide by hanging (by means of suffocation) himself from the toilet-pipe in his cell in Nuremberg, after having for some years made a reasonable attempt to drink himself to death.  He died with his underpants stuffed in his mouth, decades before the phrase "Eat my shorts!" began to circulate in popular culture.

Joachim von Ribbentrop (1893–1946; Nazi foreign minister 1938-1945): Hanged at Nuremberg after being convicted on all four counts.

Dr Joseph Goebbels: With his wife (Magda Goebbels (née Ritschel; 1901-1945), committed suicide (by gunshot) in the courtyard above the Führerbunker, shortly after they’d murdered their six young children.

Heinrich Himmler (1900–1945; Reichsführer SS 1929-1945): Captured by the British while attempting to escape disguised as a soldier, he committed suicide using an ampule of KCN concealed in his mouth.

Whether Hess was at any point insane (in the legal or medical sense) remains debated although, as is often the case, more interesting still is the speculation about just when the instability began.  Whether any credence can be attached to the official statement on the matter from the Nazi Party is doubtful but in the view of Reich Chancellery, his madness predated his flight to Scotland in 1941 (one of the strangest incidents of World War II (1939-1945)).  What the German press was told to publish was that Hess had become "deluded and deranged", his mental health affected by injuries sustained during World War I (1914-1918) and that he'd fallen under the influence of astrologers.  Just to make that sound convincing, the police conducted a crackdown (a well oiled technique in the Nazi state) on soothsayers and fortune-tellers.  Dr Joseph Goebbels (1897-1945; Nazi propaganda minister 1933-1945) wasn't consulted before the "madness" explanation was announced and he seems to have been the only senior figure in the regime to grasp the potential implications of revealing to the public that for some time the country's deputy leader had been mad.  Others though did make the connection.

When Hermann Göring tried to shift the blame to aircraft designer and manufacturer Willy Messerschmitt (1898–1978) because he'd provided Hess a twin-engined Bf 110 Zerstörer (destroyer (heavy fighter)) for his flight, the engineer responded by saying Göring was more culpable because he should have done something about having someone unstable serving as Deputy Führer.  Göring could only laugh and told Messerschmitt to go back to building warplanes and, as it turned out, the strange affair was but a "nine day wonder" for not only did the British make no attempt to use Hess's arrival on their soil for propaganda purposes (which astonished Goebbels) but other events would soon dominate the headlines.  The only place where the strange flight left a great impression was in the Kremlin where comrade Stalin (1878-1953; Soviet leader 1924-1953) for years mulled over who within the British establishment might have conspired with Hess to allow the UK to withdraw from the conflict, leaving Germany able to invade Russia without having to fight on two fronts.  Historians have concluded the reluctance by the British to use for propaganda the arrival of Hess was their concern comrade Stalin might suspect collusion.  Amusingly, although Hitler and his circle handled the “madman” explanation ineptly, that was the approach recommended by Hess.  The erstwhile Deputy Führer had written a typically rambling letter which he ensured would reach Hitler’s hands only after his arrival in Scotland and it concluded with a helpful passage: “And if my Führer, this project – which I admin has only a small chance of success – ends in failure and the fates decide against me, this can have no detrimental results either for you or Germany: it will always be possible for you to deny all responsibility.  Simply say I was crazy.”

Actually, it was not as simple as that as someone more politically aware than Hess would have understood but he was after all a man who imagined the path to a negotiated settlement with the British was to be had from discussions with Dukes and other aristocrats who would arrange for him a meeting with the King who, once persuaded of the soundness of what was being explained, would dismiss the warmongers in government and all would be well.  One wonders if Hess had ever read an explanation of Britain’s constitutional arrangements and if so, whether he’s got as far as the chapters covering things after the thirteenth century.  It would have taken Hitler a minute or two to reach the “media management” strategy recommended by Hess because the letter included a lengthy description of matters such as the modifications made to his Messerschmitt Bf 110 Zerstörer (destroyer) and the intricacies of night-time navigation.  Hess doubtless would have been proud to document his achievement because it was a remarkable feat of solo flight in wartime but to Hitler it would have been just so much extraneous information although, well accustomed to his deputy’s pedantry, it’d not have surprised him.  In fairness to Hitler, badly handled though the “explanation” was, the task should have been undertaken by Dr Goebbels but, upon hearing of the business, he decamped to his country house and remained incommunicado, telling his staff: “There are situations which even the best propagandist in the world cannot cope with.”  Goebbels certainly understood the potential for a disaster in public-relations (with Germany’s allies as well as its people), telling his aide Rudolf Semler (1913-1979) that Hess’s bizarre flight was “more serious than the desertion of an army corps.”

Arthur Sinodinos, b 1957; Liberal Party functionary and minister variously 2007-2019; Australian ambassador to the US 2019-2023, right ) presenting to Donald Trump (b 1946; US president 2017-2021 and since 2025, left) his credentials as Australia's ambassador to the US, the White House, Washington DC, February 2020.

Less dramatic but perhaps medically even more remarkable than the Hess affair was the recovery from amnesia by Arthur Sinodinos, a case which deserves to enter the annals of academic psychiatry & neurology (and debatably, those of the thespians).  In Australia, royal commissions are public investigations, established by but independent of government.  Not a court, royal commissions are created to enquire into matters of public importance and, within their terms of reference, have broad powers to conduct public & in camera hearings; they can call witnesses, compelling them (under oath) to provide testimony and they deliver recommendations to government about what should be done, consequent upon their findings.  These can include recommendations for legislative or administrative changes and the prosecution of institutions or individuals and they’re of great interest because they appear to be the only institution (at least theoretically) able to compel a politician to tell the truth.  Even that power is limited though because when appearing before royal commissions, politicians seem especially prone to suffering amnesia, an obviously distressing condition which compels them frequently to utter phrases like “I can’t remember”, “I don’t recall”, “not in my recollection” etc.  In the lore of the New South Wales (NSW) bar, Mr Sinodinous, while in 2014 being questioned by an enquiry, is believed to have set a record for the frequency with which the condition manifested.  Fortunately, the enquiry handed down no adverse findings against him and almost immediately, his memory appeared miraculously to recover, enabling the Australian Liberal Party government to appoint him ambassador to the US in 2019 so there's that.  The following transcript is wholly fake news:

Donald Trump: "What did you and Joe Biden talk about?"

Arthur Sinodinous: "I can't remember."

Donald Trump: "Not to worry, he won't remember either."

In the rich slang of the NSW bar, the condition once known as RCM (Royal Commission Memory) is now also referred to as “Sinodinos Syndrome”, on the model of “Marcinkus Syndrome” which describes the medical status of Roman Catholic priests who, being investigated for this, that or the other, although seemingly fit and healthy, are never able to be certified quite well enough to be interviewed by police or other authorities.  The condition is named after Archbishop Paul Marcinkus (1922–2006; President of the Institute for the Works of Religion (the “Vatican Bank’) 1971-1989).

Alexithymia

Alexithymia (pronounced ey-lek-suh-thahy-mee-uh)

In psychiatry, a range of behaviors associated with certain conditions which manifests as a difficulty in experiencing, processing, expressing and describing emotional responses.

1973: The construct was the Ancient Greek a- (not) + λέξις (léxis) (speaking) + θυμός (thumós) (heart (in the sense of “soul”)) which deconstructs as a- +‎ lexi +‎ -thymia (in a medical context a suffix meaning “one’s state of mind”), alexithymia thus understood as “without words for emotions”.  Alexithymia is a noun and alexithymic & alexithymiac are nouns & adjectives; the noun plural of alexithymia is also alexithymia but alexithymics, the plural of alexithymic is the more common form.

The word alexithymia was in 1973 coined by US based psychiatrists John Nemiah (1918–2009) and Peter Sifneos (1920-2008) to describe a psychological state as well known to the general population as the profession, the former preferring terms “emotionless”, “taciturn”, “feelingless” or “impassive” although alexithymia has meanings which are more specific.  Translated literally as “no words for emotions”, in practice it’s a spectrum condition which references individual degrees of difficulty in recognizing, processing or expressing emotional states or experiences.  Although it appears in both the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) and the World Health Organization’s (WHO) International Classification of Diseases (ICD), neither class it as either a diagnosable mental disorder or a symptom.  Instead, it should be regarded as a dimensional construct and one distributed normally in the general population.  In other words it’s a personality trait and like all spectrum conditions, it varies in frequency and intensity between individuals.

Alexithymia was first described as a psychological construct characterized by difficulties in identifying, describing, and interpreting one's emotions but it was soon realized individuals less able to recognize and express their own feelings would often have a diminished ability to understand the emotional experiences of others.  Clinically, alexithymia is classified in two sub-groups: (1) Primary (or Trait) Alexithymia is considered more stable and enduring and the evidence suggests there is often a genetic or developmental basis, those with primary alexithymia displaying indications from an early age.  (2) Secondary (or State) Alexithymia is something usually temporary and often associated with specific psychological or medical conditions, noted especially in patients suffering post-traumatic stress disorder (PTSD) and depressive illnesses.

Available for both Android and iOS, there are Alexithymia apps and it's possible there are those who wish to increase the extent of at least some aspects of the condition in their own lives, the apps presumably a helpful tool in monitoring progress in either direction.  There must be emos who would like to be more alexithymic. 

The characteristics common to alexithymia include (1) a limited imaginative capacity and “fantasy life”, (2) a difficulty in identifying and describing emotions, (3) thought processes which focus predominately on external events rather than internal emotional experience, (3) a difficulty in distinguishing between emotions and bodily sensations and (4) challenges in understanding (or even recognizing) the emotions of others.  As a spectrum condition, alexithymia greatly can vary in severity, and not all with alexithymia will experience the same symptoms with there being a high instance reported among patients with psychiatric and psychosomatic disorders.  Additionally, it does seem a common feature of neurological disease with most evidence available for patients with traumatic brain injury, stroke, and epilepsy although the numbers may be slanted because of the greater volume of study of those affected and it remains unclear how independent it is from affective disorders such as depression and anxiety, both common in neurological conditions.

A sample from the validation study of the Toronto Alexithymia Scale (TAS-26) (in the Croatian population).

Clinicians have available a number of questionnaires which can be use to assess a patient’s state of alexithymia and these can do more than provide a metric; the limitation of drawing a conclusion from observation alone is that with such an approach it can genuinely be impossible to distinguish between the truly alexithymic and those who have no difficulties in experiencing, processing, expressing and describing emotional responses but for some reason choose not to.  Such behavior can of course induce problems in inter-personal relationships but it’s something distinct from alexithymia and importantly too, it is clinically distinct from psychiatric personality disorders, such as antisocial personality disorder.  However, as a structural view of the DSM over the seventy-odd years would indicate, within psychiatry, mission creep has been a growing phenomenon and the definitional nets tend to be cast wide and wider and it’s not impossible that alexithymia may in some future edition be re-classified as a diagnostic criterion or at least recognized formally as a symptom.  It has for some time been acknowledged the DSM has over those decades documented the reassessment of some aspects of the human condition as mental disorders but what is less discussed is the relationship between cause and effect and there will be examples of both: it would be interesting to try to work out if there’s a pattern in the nature of (1) the changes the DSM has driven compare with (2) those which retrospectively have been codified.

Lindsay Lohan and her lawyer in court, Los Angeles, December 2011,

There may be movement because alexithymia has many of the qualities and attributes which appeal to both academia and the pharmaceutical industry.  The orthodoxy is that it occurs in some 10% of the general population but is disproportionately seen in patients suffering certain mental conditions, notably neuro-developmental disorders; the prevalence among those with autism spectrum disorder (ASD) estimated at anything up to 90%.  What will probably surprise few is that within any sub-group, it is males who are by far the most represented population and there is even the condition normative male alexithymia (NMA) although that describes the behavior and not the catchment, NMA identified also in females.

Fracture

Fracture (pronounced frak-cher)

(1) The breaking of a bone, cartilage, or the like, or the resulting condition.

(2) The act of breaking; state of being broken.

(3) A division, break, breach, or split.

(4) The characteristic manner or appearance of breaking.

(5) In mineralogy, the characteristic appearance of the surface of a freshly broken mineral or rock; the way in which a mineral or rock naturally breaks

(6) To cause or to suffer a fracture in (a bone, etc).

(7) As Fraktur, a typeface of German origin.

Early 1400s: From the Middle English fracture (a breaking of a bone), from the fourteenth century Old French fracture, from the Latin fractūra (a breach, fracture, cleft), from fractus, past participle of frangere (to break), from the primitive Indo-European bhreg (to break) and a doublet of fraktur.  The sense of "a broken surface" dates from 1794.  As a transitive verb meaning “cause a fracture in”, use appears to have begun in the 1610s (implied in fractured) and the intransitive meaning "become fractured" is from 1830.  Fracture & fracturer are nouns, fractured & fracturing (used with an object) are verbs, fracturable, fractured & fractural are adjectives.

The Dürers Fraktur typeface.

The noun fraktur (German black-lettering) dates from 1886 from the German Fraktur (black-letter, Gothic type), also "a fracture, a break", again from the Latin fractūra and so- called because of the styles angular (ie “broken") letters.  Fraktur became a common style in German printing from circa 1540 and was later exported to the Pennsylvania German arts that incorporate the lettering.  Scholars consider Fraktur a fusion of the Textur and Schwabacher letter-forms, the characteristics of Textur evident in the Fraktyr minuscules.  Schwabacher, another black-letter form, was widely used in early German print typefaces and was still in use until the mid twentieth century by which time use was entirely supplanted by Fraktur, an extensive variety of these fonts carved.  The first Fraktur typeface was designed when Maximilian I (1459–1519; King of the Romans 1486-1519 & Holy Roman Emperor 1508-1519) commissioned a series of books and ordered a new typeface created specifically for this publication; this first iteration of Fraktur was designed by Hieronymus Andreae (circa 1490-1556), a craftsman noted also for his woodcuts.  

Fonts in transition: Nazi Party poster advertising a “Freedoms Rally” (the irony not apparent at the time), Schneidemuhl, Germany, (now Pila, Poland) in 1931 (left), Edict issued by Martin Bormann (1900–1945) banning the future use of Judenlettern (Jewish fonts) like Fraktur (the irony of the letterhead being in the now banned typeface presumably didn’t disturb the author) (centre) and (in modern Roman script), an announcement in occupied that 100 Polish hostages had been executed as a reprisal for death of two Germans in Warsaw, 1944 (right).

Sometimes, the message was the typeface itself; it imparted values that were separate from the specific meaning in the text.  The Nazi regime (1933-1945) in Germany was always conscious of spectacle and although in matters of such as architecture customs there was a surprising tolerance of regional difference, in some things it demanded uniformity and one of those was the appearance of official documents.  Early in his rule their rule, Adolf Hitler (1889-1945; Führer (leader), German head of government 1933-1945 & head of state 1934-1945) decreed that “German Black Letter” should be used for all official purposes (and it was used in the cover art of most early editions of Mein Kampf); Hitler, who to the end thought himself an “artist”, liked the heavy, angular form for its encapsulation of the Germanic.  Fraktur is probably the best known of these although it’s but one of a number of variations of the typeface and such was the extend of the state support for the font that the party was critical of newspapers, publishers & magazines which used more modern (and easier to read) forms (and they were used by the German military and civil service when legibility was important), a frequent criticism being the “Roman characters” somehow represented a “Jewish influence”.  In one of the ironies of history however, when it became apparent that when used in letters and notices distributed to enforce rule in the occupied territories the use of the font was counter-productive because it was so hard to read, the Nazis suddenly declared that Fraktur had become contaminated wand was thus proscribed as Judenlettern (Jewish letters), official documents thereafter rendered in modern Roman type.  Martin Bormann's edict was issued thus:

I announce the following, by order of the Führer:

It is false to regard the so-called Gothic typeface as a German typeface. In reality, the so-called Gothic typeface consists of Schwabacher-Jewish letters. Just as they later came to own the newspapers, the Jews living in Germany also owned the printing presses… and thus came about the common use in Germany of Schwabacher-Jewish letters.

Today the Führer… decided that Antiqua type is to be regarded as the standard typeface. Over time, all printed matter should be converted to this standard typeface. This will occur as soon as possible in regard to school textbooks, only the standard script will be taught in village and primary schools. The use of Schwabacher-Jewish letters by authorities will in future cease. Certificates of appointment for officials, street signs and the like will in future only be produced in standard lettering…

Broken bones, fractured bones

There’s a widespread perception among lay-people that when it comes to broken bones, there’s a difference between a fracture and a break, a fracture being a kind of crack which doesn’t result in a clear separation whereas in a break, there’s a visible gap between the two broken pieces.  However, to physicians, the two mean the same thing, the only difference being that “fracture” is the preferred medical jargon, whereas a “break” is just a term sometimes used casually with customers (whom they prefer to call patients).  Anatomists list fourteen distinguishing characteristics of fractures, adding that injuries may result in some overlap in the categorization and (at least) a duplication of terminology in any description.

(1) Avulsion fracture: A muscle or ligament pulls on the bone, fracturing it.

(2) Comminuted fracture: An impact shatters the bone into many pieces.

(3) Compression, or crush, fracture: This generally occurs in the spongy bone in the spine. For example, the front portion of a vertebra in the spine may collapse due to osteoporosis.

(4) Fracture dislocation: This occurs when a joint dislocates, and one of the bones of the joint fractures.

(5) Greenstick fracture: The bone partly fractures on one side but does not break completely, because the rest of the bone can bend.

(6) Hairline fracture: This is a thin, partial fracture of the bone.

(7) Impacted fracture: When a bone fractures, a piece of the bone may impact another bone.

(8) Intra-articular fracture: This occurs when a fracture extends into the surface of a joint.

(9) Longitudinal fracture: This is when the fracture extends along the length of the bone.

(10) Oblique fracture: An oblique fracture is one that occurs opposite to a bone’s long axis.

(11) Pathological fracture: This occurs when an underlying condition weakens the bone and causes a fracture.

(12) Spiral fracture: Here, at least one part of the bone twists during a break.

(13) Stress fracture: Repeated stress and strain can fracture a bone. This is common among athletes.

(14) Transverse fracture: This is a straight break across the bone.

Bones are (substantially) rigid organs that support and protect many organs as well as producing red and white blood cells and storing minerals.  While there are variations, a typical adult human has 206 separate bones which, although tough and sometimes slightly flexible to absorb stress, if the pressure sustained is beyond a certain point, the bone will fracture.  In casual use, this is called a “broken bone” but to physicians it’s always a fracture which means simply there’s a break in the continuity of the bone. Symptoms vary, including pain, bones protruding through the skin, swelling, distortion in the appearance of body parts (especially limbs & digits) and loss of function.  Generally, bone fractures are either traumatic or pathological.  A traumatic fracture is where blunt force trauma has been applied such as the impact injuries sustained by falling or hitting something hard.  Pathological fractures are those which are the result of diseases such as Osteoporosis, chronic kidney or liver conditions, rickettes and hypovitaminosis D.

Fractures are sub-classified by anatomical location (skull fracture, rib fracture etc (an in casual use broken arm, broken leg etc)).  Physicians further refine their descriptions by mapping on an orthopaedic schematic in which fractures are defined by their state such as open fracture (bone is visible and the skin ripped), closed fracture (skin is intact), compression fractures, incomplete fracture, linear fracture etc.  Bone fractures are now most often diagnosed through imaging, most commonly with X-rays and treatment consists of pain management, keeping bones intact with splints or screws (or surgery depending on severity).  In extreme cases, amputation may be required if an infection can’t be controlled.

Break was from the Middle English breken, from the Old English brecan (to divide solid matter violently into parts or fragments; to injure, violate (a promise, etc), destroy, curtail; to break into, rush into; to burst forth, spring out; to subdue or tame), from the Proto-West Germanic brekan, from the Proto-Germanic brekaną & brekanan (to break), from the primitive Indo-European bhreg- (to break) and a doublet of bray.  Etymologists list the brecan as a (class IV) strong verb; past tense bræc, past participle brocen), the Proto-Germanic brekanan source also of the Old Frisian breka, the Dutch breken, the Old High German brehhan, the German brechen and the Gothic brikan), all ultimately from the primitive Indo-European root bhreg- (to break).

It was related closely to the nouns breach, brake & brick. The old past tense brake is obsolete or archaic and while still sometimes erroneously used, it’s long been an irregular form.  The past participle is broken but the shortened form broke is attested from the fourteenth century and the Oxford English Dictionary reported it was "exceedingly common" in the seventeenth & eighteenth century.  The meaning in the Old English applied to bones but formerly had been used also of also of cloth, paper and other fabrics, the meaning "escape by breaking an enclosure" dating from the late fourteenth century whereas the intransitive sense "be or become separated into fragments or parts under action of some force" was known by the late twelfth and the sense of "lessen, impair" was noted in the late fifteenth.  

Forks in the meaning emerged continuously: "make a first and partial disclosure" is from early 1200s and "destroy continuity or completeness" in any way is from 1741.  As applied to physical legal tender (coins or bills), break was being used to describe “converting a larger unit into smaller units of currency" by 1882 although the oral tradition may have long predated this.  That favorite of authors and poets, the “break her heart” is an intransitive verb from the fourteenth century.  To break bread (share food with someone) is from the late 1300s while to break ground (to dig or plough) was noted first in 1674 while the now rare figurative sense "begin to execute a plan" is from 1709.  To break the ice in the sense of "overcome the feeling of restraint in a new acquaintanceship" is from circa 1600, the reference an allusion to the "coldness" found sometimes in encounters with strangers.  To break wind was first attested in the 1550s although it may have been long used as one of the many way of describing this ancient practice.  To break (something) out is though probably is an image from dock work, of freeing cargo before unloading it and it is documented from the 1890s.

Lindsay Lohan with broken left wrist (fractured in two places in an unfortunate fall at Milk Studios during New York Fashion Week) and 355 ml (12 fluid oz) can of Rehab energy drink, Los Angeles, September 2006.  The car is a 2005 Mercedes-Benz SL 65 (R230; 2004-2011) which earlier had featured in the tabloids after a low-speed crash.  The R230 range (2001-2011) was unusual because of the quirk of the SL 550 (2006-2011), a designation used exclusively in the North American market, the RoW (rest of the world) cars retaining the SL 500 badge even though both used the 5.5 litre (333 cubic inch) V8 (M273).

While the ironic theatrical good luck formula “break a leg” appears not to have been documented until 1948, it’s thought to have been in use since at least the 1920s and has a parallels in the German Hals- und Beinbruch (break your neck and leg) and the similar Italian in bocca al lupo. (into the wolf's mouth), the standard response to which is crepi il lupo! (may the wolf die), truncate usually as simply crepi! (may it die) although, in a sign of the times, the animal welfare lobby has suggested viva il lupo! (may the wolf live) but this is said not to have caught on with the thespians.  According to one dictionary of etymology, the expression “break a leg” was in the seventeenth century used euphemistically, of a woman, "to have a bastard" although whether this had any relationship to the traditions of theatre isn’t noted.

The noun break (act of breaking, forcible disruption or separation) was derived from the verb circa 1300 and the break of day "first appearance of light in the morning" dates from the 1580s, that senses extended by 1725 to mean any "sudden, marked transition from one course, place, or state to another".  The sense of a "short interval between spells of work" applied originally between lessons at school and was from 1861, enduring to this day in concepts such as the notorious “spring breaks”.  The “lucky break” meaning "stroke of good luck" is attested by 1911, thought to be drawn from the game of billiards (where the break that scatters the ordered balls and starts the game is attested from 1865). The now archaic meaning "stroke of mercy" is from 1914 and the use in Jazz music to describe an "improvised passage, solo" is from 1920s.  Broadcasting adopted the term in 1941 and applied it variously to handle the intervals between programmes although it was later augmented by the “sting”, a short piece of music to cover any break.  The "mini-break" is a (UK) colloquial term for a short "holiday" of 2-3 days; it was popularized in Helen Fielding's (b 1958) 1996 novel Bridget Jones's Diary and is used sometimes as a euphemism for a dirty weekend.