Psychosis

Psychosis (pronounced sahy-koh-sis)

In psychiatry, a severe mental disorder (sometimes with physical damage to the brain), more serious than neurosis, characterized by disorganized thought processes, disorientation in time and space, hallucinations, delusions and a disconnection from reality.  Paranoia, manic depression, megalomania, and schizophrenia are all psychoses.

1847: From the New Latin & Late Greek psȳ́chōsis, the construct being psycho- + -osis, the source being the Ancient Greek ψύχωσις (psúkhōsis) (animation, principle of life), psych from the Ancient Greek ψυχή (psukhḗ or psykhē) (mind, life, soul).  The suffix –osis is from the Ancient Greek -ωσις (-ōsis) (state, abnormal condition or action), from -όω (-óō) (stem verbs) + -σις (-sis); -oses was the plural form and corresponding adjectives are formed using –otic, thus respectively producing psychoses and psychotic.  The Ancient Greek psykhosis meant "a giving of life; animation; principle of life".  In English, the original 1847 construction meant "mental affection or derangement" while the adjective psychotic (of or pertaining to psychosis) dates from 1889, coined from psychosis, on the model of neurotic/neurosis and ultimately from the Ancient Greek psykhē (understanding, the mind (as the seat of thought), faculty of reason).

In clinical use there are many derived forms (with meanings more precise than is often the case when such words migrate to general use) including antipsychotic, micropsychotic, neuropsychotic, nonpsychotic, postpsychotic, prepsychotic, propsychotic, protopsychotic, quasipsychotic, semipsychotic & unpsychotic.  The useful portmanteau word sarchotic (the construct a blend of sarcastic +‎ psychotic) is used to describe a statement so distrubingly sarcastic it can't be certain if the remark is intended to be humerous or the person making it genuinely is psychotic and even then there are graduations for which the adverb is used, the comparative being "more psychotically" and the superlative "most psychotically".  Psychosis & psychoticism are nouns, psychotic is a noun & adjective and psychotically is an adverb; the noun plural is psychoses.

Psychosis and the DSM

The word psychosis was a mid-nineteenth century creation necessitated by early psychiatry’s separation of psychiatric conditions from neurological disorders.  Originally a generalized concept to refer to psychiatric disorders, gradually it became one of the major classes of mental illness, assumed to be the result of a disease process, and, more recently, to a symptom present in many psychiatric disorders.  During this evolution, the diagnostic criteria shifted from the severity of the clinical manifestations and the degree of impairment in social functioning to the presence of one or more symptoms in a set of psychopathological symptoms.  By the early twentieth century, the concept of neurosis (which once embraced both the psychiatric and the neurological disorders), became restricted to one major class of psychiatric disease whereas psychosis (which once embraced all psychiatric disorders) became restricted to the other.

The first consensus-based classification with a description of diagnostic terms was in the first edition (DSM-I (1952)) of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) in which mental disorders were divided into two classes of illness: (1) organic disorders, caused by or associated with impairment of brain tissue function; and (2) disorders of psychogenic origin without clearly defined physical cause or structural changes in the brain.  When DSM-II (1968) was released, the classifications were revised with mental disorders now classed as (1) psychoses and (2) neuroses, personality disorders, and other non-psychotic mental disorders.  Psychosis was defined as a mental disorder in which mental functioning is impaired to the degree that it interferes with the patient's ability to meet the ordinary demands of life and recognize reality.

Advances in both neurology and psychiatry led to an extensive revision in DSM-III (1980).  Radically, all traditional dichotomies (organic versus functional, psychotic versus neurotic etc) were discarded with psychiatric syndromes assigned to one of fifteen categories of disease.  At the labelling level, the term psychotic was used to describe a patient at a given time, or a mental disorder in which at some time during its course, all patients evaluate incorrectly the accuracy of their perceptions and thoughts but the editors emphasized it should not be applied to patients suffering only minor distortions of reality, regardless of how exactly they might fulfil the clinical criteria.  The revisions in DSM-III-R (1987) extended only to slight changes in terminology.

Mirroring the changes in diagnostic criteria published by the WHO, DSM-IV (1994) noted the diagnosis of psychosis should no longer be based on the severity of the functional impairment but rather on the presence of certain symptoms which included delusions, hallucinations, disorganized speech and grossly disorganized or catatonic behavior.  This emphasis on psychoses being spectrum conditions was continued in DSM-5 (2013) with schizoid (personality) disorder and schizophrenia defining its mild and severe ends.  Additionally, a more precise diagnostic framework was defined in which patients were assessed in terms both of symptoms and duration of suffering.

Two examples of "schizophrenia art".

My Eyes in the Time of Apparition (1913) by August Natterer (1868-1938).

The life of German artist August Natterer began innocuously enough, studying engineering, travelling extensively, marrying and building a successful career as an electrician.  However, in his thirties, he began to experience anxiety attacks and delusions and in 1907 suffered a hallucination in which thousands of images flashed before his eyes in little more than thirty minutes.  So affected by the experience that he attempted suicide, he was admitted to an asylum and would spend the remaining quarter-century of his life in and out of institutes for the insane.  In the literature, Natterer is referred to as Neter, a pseudonym used by his psychiatrist to protect patient and family from the social stigma then associated with mental illness.  He described the 1907 hallucination as a vision of the Last Judgment which he described as:

"...10,000 images flashed by in half an hour.  I saw a white spot in the clouds absolutely close – all the clouds paused – then the white spot departed and stood all the time like a board in the sky. On the same board or the screen or stage now images as quick as a flash followed each other, about 10,000 in half an hour… God himself occurred, the witch, who created the world – in between worldly visions: images of war, continents, memorials, castles, beautiful castles, just the glory of the world – but all of this to see in supernal images. They were at least twenty meters big, clear to observe, almost without color like photographs… The images were epiphanies of the Last Judgment. Christ couldn't fulfil the salvation because he was crucified early... God revealed them to me to accomplish the salvation."

After his suicide attempt and committal to the first of what would be several mental asylums, Natterer thereafter maintained that he was the illegitimate child of Emperor Napoleon I (Napoleon Bonaparte (1769–1821; leader of the French Republic 1799-1804 & Emperor of the French from 1804-1814 & 1815)) and "Redeemer of the World".  The vision inspired Natterer to a prolific production of drawings, all documenting images and ideas seen in the vision, one especially interesting to those studying psychosis and schizophrenia being My Eyes in the Time of Apparition (1913), two eyes bloodshot and wide-open eyes staring from the page.  The irises of the eyes do not match.

The Scream (1893), oil, tempera & paste on cardboard, by Edvard Munch (1863-1944), National Gallery of Norway.

Norwegian Edvard Munch was one of a number of artists modern psychiatrists have written of as having both genetic and environmental predispositions to mental illness, schizophrenia in particular; one of Munch’s sisters had schizophrenia, his father suffered from depression, his mother and another sister dying from tuberculosis when he was young.  Munch though was a realist, once telling an interviewer, “I cannot get rid of my illnesses, for there is a lot in my art that exists only because of them.”  The idea of affliction as a source or artistic inspiration appears often in the literature of art, music and such and in that it's something of a parallel with those who produce their finest work while living under political oppression; unpleasant as that can be, reform can see careers suffer, famous dissidents abruptly left as "rebels without a cause" after the fall of the Soviet Union (1922-1991) and a generation of the UK's activists found grist for their mills less prolific after the Tory Party had Margaret Thatcher (1925–2013; UK prime-minister 1979-1990) walk the political plank.  Where one door closes however, another sometimes opens and in John Major (b 1943; UK prime-minister 1990-1997) the comedians found a rich vein of material.    

His was a troubled life and in 1908, following a psychotic break exacerbated by alcoholism, Munch was admitted to a mental health clinic, later diagnosed with neurasthenia, a clinical condition now known to be closely associated with hypochondria and hysteria.  Adding to his problems, the Nazis labelled Munch’s style “degenerate art” and in 1937 confiscated many of his works but their disapprobation had less of an influence on his painting than his schizophrenia, his output continuing to feature figures obviously tortured by anguish and despair.  The apparently frantic strokes of the brush and his seemingly chaotic pallet of colors have long intrigued both critics and clinicians seeing insight into his state of mind, the idea being his paintings provide something of a visual representation of how schizophrenia might lead individuals to see the world.

Lindsay Lohan, following Edvard Munch, rendered by Vovsoft in comicbook style.

Endlessly reproduced, the subject of numerous memes and the inspiration for many re-interpretations, The Scream is Munch’s most famous work and the most emblematic of what now casually is called “schizophrenic art” (unfortunately often conflated with “art by schizophrenics”).  For decades it has been the chosen artistic representation for the angst-ridden modern human condition, the artist in 1890 noting in his diary a still vivid memory: “I was walking along the road with two friends—the sun went down—I felt a gust of melancholy—suddenly the sky turned a bloody red... I felt this big, infinite scream through nature.”  That entry was written some years after the sight and before painting The Scream in 1893 but the moment stayed with him because his vision of the sky caused him to “tremble with pain and angst” and he felt he heard his “…scream passing endlessly through the world.”  For historians those fragment of memory proved of interest and in his book Krakatoa:The Day the World Exploded (2003), detailing the 1883 eruption of the Indonesian volcano Krakatoa, Simon Winchester (b 1944) connected the “blood red” Norwegian sky with the fiery sunsets created by the ash from the explosion circulating the planet, high in the atmosphere.

Krakatoa: The Day the world exploded.

The idea of a link between the catastrophic geological event and the painting had long intrigued art historians who understood such a sight would have appeared “surreal”, decades before the surrealism movement became established and that it was a natural phenomenon is well-supported by theoretical modelling.  Between 20 May-21 October 1883, Krakatau, a volcanic island in the Sunda Strait, erupted, the “main event” happening on 27 August, during which over two-thirds of the island and its surrounding archipelago was destroyed, the remnants subsequently collapsing into a caldera (in volcanology, a large crater formed by collapse of the cone or edifice of a volcano).  The event created a large tsunami which, much diminished, reached the Atlantic and it’s believed that day’s third explosion was history’s loudest known sound.  What Edvard Munch is thought to have seen is the evening light of the sun being colored by the millions of tons of sulfur dioxide and volcanic dust blasted high into the atmosphere, circulating there for years including over Oslo when the artist was taking his walk.  Nor was he wholly wrong in suggesting “a scream passing” because such was energy generated by the explosion, the acoustic pressure wave circled the globe at least three times.

Solemncholy

Solemncholy (pronounced sol-uhm-kol-ee)

(1) Solemn; serious.

(2) Solemn and melancholic.

1772: The construct was solemn +‎ (melan)choly.  The element –choly was never a standard suffix and was a Middle English variant of –colie used in French.  The Middle English adjective solemn dated from the late thirteenth century and was from solemne & solempne, from either Old French or directly from the Late Latin sōlennis & sōlempnis or the Classical Latin sōlemnis, a variant of sollemnis (consecrated, holy; performed or celebrated according to correct religious forms) which has always been of obscure origin although Roman scholars thought it could have come only from sollus (whole; complete), the derivative adjective formed by appending the noun annus (year), thus the idea of sollemnis meaning “taking place every year”.  Not all modern etymologists are convinced by that but acknowledge “some assimilation via folk-etymology is possible”.  In English, the extension of meaning from “annual events; sacred rites, ceremonies, holy days” to “a grave and serious demeanor; mirthless” was associative describing the behaviour expected of individuals attending such events.  Over time, the later sense became dissociated from the actual events and the original meaning became obsolete, surviving only in a handful of formal ecclesiastical calendars.  The word, without any reference to religious ceremonies meaning “marked by seriousness or earnestness” was common by the late fourteenth century, the sense of “fitted to inspire devout reflection” noted within decades.    Solemncholy is an adjective and no sources list the noun solemncholic or the adverb solemncholically as standard forms although, by implication, the need would seem to exist.  Emos presumably apply the adjectival comparative (more solemncholy) & superlative (most solemncholy) and perhaps too (during emo get-togethers) the plural forms solemncholics & solemncholies.

Melancholy was from the Middle English melancolie & malencolie (mental disorder characterized by sullenness, gloom, irritability, and propensity to causeless and violent anger), from the thirteenth century Old French melancolie (black bile; ill disposition, anger, annoyance), from the Late Latin melancholia, from the Ancient Greek μελαγχολία (melancholia) (atrabiliousness; sadness, (literally “excess of black bile”)), the construct being μέλας (mélas) or μελαν- (melan-) (black, dark, murky) + χολή (kholḗ) (bile).  It appeared in Latin as ātra bīlis (black bile) and was for centuries part of orthodox medical diagnosis and the adjectival use was a genuine invention of Middle English although whether the used of the –ly as a component of the suffix was an influence or a product isn’t known.  Pre-modern medicine attributed what would now be called “depression” to excess “black bile”, a secretion of the spleen and one of the body's four “humors” which needed to be “in balance” to ensure physical & mental well-being.  The adjectival use in Middle English to describe “sorrow, gloom” was most associated by unrequited love or doomed affairs but this is likely more the influence of poets than doctors.  As the medical profession’s belief in the four humors declined during the eighteenth century as understanding of human physiology improved, the word was in the mid-1800s picked up by the newly (almost) respectable branch of psychiatry where it remained a defined “condition” until well into the twentieth century.

The physicians from Antiquity attributed mental depression to unnatural or excess "black bile," a secretion of the spleen and one of the body's four "humors," which help form and nourish the body unless altered or present in excessive amounts. The word also was used in Middle English to mean "sorrow, gloom" (brought on by unrequited love, disappointment etc).  In antiquity it was a concept rather than something with a standardized systemization and there existed competing models with more or fewer components but it’s because the description with four was that endorsed by the Greek physician Hippocrates (circa 460–circa 370 BC) that it became famous in the West and absorbed into medical practice.  The four humors of Hippocratic medicine were (1) black bile (μέλαινα χολή (melaina chole)), (2) yellow bile (ξανθη χολή (xanthe chole)), (3) phlegm (φλέγμα (phlegma)) & (4) blood (αἷμα (haima)), each corresponding with the four temperaments of man and linked also to the four seasons: yellow Bile=summer, black bile=autumn, phlegm=winter & blood=spring.  Since antiquity, doctors and scholars wrote both theoretical and clinical works, the words melancholia and melancholy used interchangeably until the nineteenth century when the former came to refer to a pathological condition, the latter to a temperament.  Depression was derived from the Latin verb deprimere (to press down) and from the fourteenth century, "to depress" meant to subjugate or to bring down in spirits and by 1665 was applied to someone having "a great depression of spirit", Dr Johnson (Samuel Johnson, 1709-1784) using the word in a similar sense in 1753.  Later, the term came into use in physiology and economics.

What was for over two-thousand years known as melancholia came gradually to be called depression, a reclassification formalized in the mid-twentieth century when mental illness was subject to codification.  The first edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM (1952)) included depressive reaction and the DSM-II (1968) added depressive neurosis, defined as an excessive reaction to internal conflict or an identifiable event, and also included a depressive type of manic-depressive psychosis within the category of Major Affective Disorders.  The term Major Depressive Disorder was introduced by a group of US clinicians in the mid-1970s and was incorporated into the DSM-III (1980).  Interestingly, the ancient idea of melancholia survives in modern medical literature in the notion of the melancholic subtype but, from the 1950s, the newly codified definitions of depression were widely accepted (although not without some dissent) and the nomenclature, with enhancements, continued in the DSM-IV (1994) and DSM-5 (2013)

According to the Oxford English Dictionary (OED), the earliest known instance of solemncholy in text dates from 1772 in the writings of Philip Vickers Fithian (1747–1776), peripatetic tutor, missionary & lay-preacher of the Presbyterian denomination of Christianity, now best remembered for his extensive diaries and letters which continue to provide historians with source material relating to the pre-revolutionary north-eastern colonies which would later form the United States of America.  His observations on slavery and the appalling treatment of those of African origin working the plantations in Virginia remain a revealing counterpoint to the rationalizations and justifications (not infrequently on a theological or scriptural basis) offered by many other contemporary Christians.  Those dictionaries which include an entry for solemncholy often note it as one of the humorous constructions in English, based usually on words from other languages or an adaptation of a standard English form.  That’s certainly how it has come to be used but Fithian was a Presbyterian who aspired to the ministry, not a breed noted for jocularity and in his journal entries its clear he intended to word to mean only that he was pursuing serious matters, in 1773 writing: “Being very solemncholy and somewhat tired, I concluded to stay there all night.”

So it was an imaginative rather than a fanciful coining.  In contemporary culture, with mental health conditions increasingly fashionable, solemncholy (although still sometimes, if rarely, used in its original sense) found a new niche among those who wished to intellectualize their troubled state of mind and distinguish their affliction from mere depression which had become a bit common.  In a roundabout way, this meant it found a role too in humor, a joke about someone’s solemncholy still acceptable whereas to poke fun at their depression would be at least a micro-aggression:

Q: Victoria says she suffers from solemncholy.  Do you think that's a real condition?

A: Victoria is an emo; for her solemncholy is a calling.

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

The companion term to solemncholy is the sometimes acronym leucocholy (a state of feeling that accompanies preoccupation with trivial and insipid diversions).  The construct of leucocholy was leuco- + (melan)choly.  The leuco- prefix (which had appeared also as leuko-, leuc- & leuk-) was from the Proto-Hellenic λευκός (leukós) (white; colourless; leucocyte), from the primitive Indo-European lewk- (white; light; bright), the cognates including the Latin lūx, the Sanskrit रोचते (rocate), the Old Armenian լոյս (loys) and the Old English lēoht (light, noun) from which English gained “light”.  In the Ancient Greek, the word evolved to enjoy a range or meanings, just as in would happen English including (1) bright, shining, gleaming, (2) light in color; white, (3) pale-skinned, weakly, cowardly & (4) fair, happy, joyful.  Leucocholy is said to have been coined by the English poet and classical scholar Thomas Gray (1716–1771) whose oeuvre was highly regarded despite being wholly compiled into one slim volume and he’s remembered also for declining appointment as England’s Poet Laureate, thereby forgoing the both the tick of approval from the establishment and the annual cask of “strong wine” which came with the job.  What he meant by a “white melancholy” seems to have been a state of existence in which there may not be joy or enchantment but is pleasant: unfulfilling yet undemanding.  In such a state of mind, as he put it:  ca ne laisse que de s’amuser (which translates most elegantly as something like “all that is left for us is to have some fun”).

Surreal

Surreal (pronounced suh-ree-uhl (U) or sur-reel (non-U))

(1) Of, relating to, or characteristic of surrealism, an artistic and literary style; surrealistic.

(2) Having the disorienting, hallucinatory quality of a dream; unreal; fantastic & and incongruous.

(3) As surrealism, an artistic movement and an aesthetic philosophy that, inter alia, explored the “liberation of the mind” by emphasizing the critical and imaginative powers of the subconscious.

(4) In mathematics as surreal numbers, a collection of numbers which includes both the real numbers and the infinite ordinal numbers, each real number surrounded by surreals, which are closer to it than any real number.

1936: A back formation from surrealism, the construct being ; sur- +‎ realism, from the French surréalisme, the construct being sur- (beyond) +‎ réalisme (realism).  Sur- ((over in the sense of “on top of” & over- in the sense of “excessive; excessively; too much”)) was from the Old French sur-, sour-, sor- & soure-, from a syncopation of the Latin super- (above, on top, over; upwards; moreover, in addition, besides) from the Proto-Italic super, from the primitive Indo-European upér (over, above (and cognate with the Ancient Greek ὑπέρ (hupér) (above) and the Proto-Germanic uber (which in English became “over”)).  The English sur- was from the Middle English sur-, from the Old French sur-, sour-, sor- & soure-, a syncopic form of the Latin super.  Sur is a doublet of super-, over- and hyper-.  Real was from the Middle English real, from the Old French reel, from the Late Latin reālis (actual), from the Latin rēs (matter, thing), from the primitive Indo-European rehís (wealth, goods).  Surreal is a noun & adjective, surreally is an adverb, surrealism & surreality are nouns and surrealistic is an adjective; the noun plural is surreals.

Lobster Telephone (1936) by Salvador Dali, one of a dozen-odd originals (in colors and shades of cream created by the artist).

In French, the noun surréalisme appeared first in the preface to Guillaume Apollinaire's (1880-1918) play Les Mamelles de Tirésias (1916-1917 and first performed in 1917).  The word was taken up in the 1920s by French intellectuals who created a number of (competing) Manifeste de Surréalisme (Surrealist manifesto) which were documents exploring the nature of human psychology and the way the radical imagination could produce transformative art.  Such was the nature of their texts, inspiration was offered to groups as diverse as landscape painters and anarchists and anyone else attracted to the idea (if not the business) of revolution.  The English form of the word appeared first in 1931, the French spelling having been in use since 1927.  Surrealist as an adjective and noun (from the 1917 French surréaliste) has been in use since 1925 while the adjective surrealistic dates from 1930.

La Trahison des Images (The Treachery of Images) (1929), oil on canvas, by Rene Magritte (1898-1967), Los Angeles County Museum of Art.

The French text Ceci n’est pas une pipe (This is not a pipe) is an act of deconstruction, a statement that a painting is a representation of something, not the object itself.  It’s a statement of the obvious but is both in the artistic tradition of opposition to oppressive rationalism and an influential strand in the history of Surrealism and Pop Art.

Mama, papa is wounded! (1927) by Yves Tanguy (1900-1955), oil on canvas, Museum of Modern Art, New York.

One of the motifs of surrealist painters was a deliberate disconnection between the title of a work and any immediately obvious meaning. Tanguy’s Mama, papa is wounded! was a painting in one of the recognized surrealist styles: a landscape of wide vista littered with abstract shapes, the title taken from a case-study in a psychiatry textbook.  Beyond mentioning he’d imagined the whole canvas before lifting a brush, Tangay gave no clue about the meaning, but coming so soon after Great War, many focused on a link with the many French causalities of the conflict, the depiction of their horrific injuries also part of an artistic movement in the post-war years.

Swans Reflecting Elephants (1937), oil on canvas by Salvador Dali (1904-1989)

Salvador Dali remains the best-known surrealist painter and Swans Reflecting Elephants is an example of his paranoiac-critical method, which attempted to use art to represent how subconscious thought might summon the irrational imagery when in a state of psychosis or paranoia.  The work is interesting too in that it’s the most perfect example of a double image, the trees and swans reflected in the mirror-like surface of the water as lake as elephants.  Dali himself would sometimes discuss the usefulness of the mirror as a device to explore the divergence between conscious reality and the world of the subconscious.

Jean-Martin Charcot, documentary photographs of hysteria patients at La Salpêtrière Asylum 1878, printed in Le Cinquantenaire de L’hystérie (La Révolution Surréaliste (1928)) by André Breton (1896–1966) & Louis Aragon (1897–1982).  Breton & Aragon lamented that hysteria (which they called "the greatest poetic discovery of the late nineteenth century") was being redefined by the new discipline of psychiatry as merely a symptom of mental illness which could be eliminated by suggestion alone.

The link between surrealist art and madness long intrigued the medical community and the interest later extended to the relationship with modernism in general.  Remarkably, it wasn’t until 1980 with the publication of the third edition (DSM-III) that the diagnosis “hysteria” was removed from the Diagnostic and Statistical Manual of Mental Disorders.  Hysteria had for centuries been a kind of omnibus diagnosis, applied to those (almost always women) displaying an extraordinary array of mental and physical symptoms, the gendered hysteria derived from the Ancient Greek word for uterus.  To many Surrealists, hysteria was the state in which a poetic expression of the mind’s wilder impulses could be unleashed, meaning that instead of being silenced, this fundamental condition of being female could usefully be objectified.  History and art met in the decade of the surrealists because the 1930s was a time to be hysterical, less about what was happening than the fear of what was to come but the reaction to the Exposition Internationale du Surréalisme, an exhibition by surrealist artists held in Paris in January-February 1938 was not despair or shock but indifference, the novelty of the form having passed, the claim the exhibition needed to be understood as a single installation convincing few.  In the history of the movement, the peak had actually passed and although surrealist works would continue to be produced (and actually mass-produced as wildly popular prints) in the post-war world, the output was repetitive.  The avant-garde having plundered from surrealism what could be carried off, explored other directions.

Woman’s Dinner Dress (February 1937) by Elsa Schiaparelli (1890-1973), printed silk organza and synthetic horsehair, Philadelphia Museum of Art.

The fragments however endure.  Elsa Schiaparelli was an Italian fashion designer who took the objects made famous by the Futurists, Dadaists, & Surrealists and integrated them into clothing, her most memorable piece a white evening gown adorned with a large Daliesque lobster.  A design which would now attract little attention, at the time it was a sensation, its audacity a contrast with the solid pastels and other subdued hues with which Coco Chanel (1883-1971) had defined Parisian sophistication.  The playful designs she adopted (a telephone-shaped handbag, buttons in the shape of lollipops, fingernail gloves and hats in shapes borrowed from industry and agriculture) were not always original but she lent them a respectability in the world of high-fashion. 

In the surreal style: Salvador Dali (2021) by Javier Peña and Lindsay Lohan by Mohamad Helmi on Displate.

Cacophony

Cacophony (pronounced kuh-kof-uh-nee)

(1) A harsh discordance of sound; dissonance.

(2) The use of inharmonious or dissonant speech sounds in language.

(3) In music, the frequent use of discords of a harshness and relationship difficult to understand.

1650-1660: From the sixteenth century French cacophonie (harsh or unpleasant sound) from the New Latin cacophonia, from the Ancient Greek κακοφωνία (kakophōnía) (ill or harsh sounding), from kakophonos (harsh sounding), the construct being being κακός (kakós) (bad, evil) + φωνή (phōnḗ) (voice, sound) from the primitive Indo-European root bha (to speak, tell, say).  The source of kakós was the primitive Indo-European root kakka (to defecate), something which may have been in mind in that notable year 1789, when first cacophony was used to mean "discordant sounds in music".  Cacophony is a noun, cacophonic & cacophonous are adjectives, cacophonously an adverb and the noun plural is cacophonies.  The most natural antonym is harmony although musicologists tend to prefer the more precise euphony.

Noise as music

There were twentieth century composers, all of whom thought themselves both experimental and somewhere in the classical tradition, who wrote stuff which to most audiences sounded more cacophonous than melodic.  Some, like Béla Bartók (1881–1945) and Arnold Schönberg (1874–1951) had a varied output but for untrained listeners seeking music for pleasure rather than originality or the shock of something new, the work of Karlheinz Stockhausen (1928–2007), Charles Ives (1874–1954) and Philip Glass (b 1937) was no fun.  Some critics however, trained or otherwise, claim to enjoy many of these cul-de-sacs of the avant-garde and find genius among the noise.  Comrade Stalin (1878-1953; Soviet leader 1924-1953) would have called them formalists.

In popular (sic) culture, Lou Reed (1942–2013) in 1975 released Metal Machine Music, either (1) to fulfil a contractual obligation to a record label with which he no longer wished to be associated, (2) to annoy critics and others he didn’t like, (3) as a piece of electronic music, (4) to win a bet with Andy Warhol (1928-1987) or (5) because he was suffering an amphetamine induced psychosis.  Known as MMM or 3M by fans and categorized by most as noise, drone, industrial or minimal, it’s about two hours of modulated feedback running at different speeds.  Despite the derision attracted at the time, it’s since built a cult following and has been performed live, one approving reviewer suggesting MMM is best understood as “…electricity falling in love with itself”.  The original release was a double album on twelve-inch vinyl and featured a “locked grove” on the final track meaning the noise endlessly would loop, theoretically forever.  This trick couldn’t be done on the new medium of the CD but there were no complaints the omission detracted from the experience.

Camisole

Camisole (pronounced kam-uh-sohl)

(1) A short garment worn underneath a sheer bodice to conceal the underwear; also called cami (pronounced kam-ee).

(2) A woman's dressing jacket or short negligée.

(3) A sleeved jacket or jersey once worn by men (now obsolete but occasionally revived as a catwalk novelty).

(4) As camisole de force, a straitjacket with long sleeves (mostly historic references).

1816: From the French and the Old Occitan (also called Old Provençal) camisola, the construct being camis(a) + -ola; the Late Latin camīsa (shirt) was also the source of chemise and the Latin suffix -ola was added to a noun to form a (sometimes pejorative) diminutive of that noun; a variant was the Late Latin camisia (shirt or nightgown).  The thread was well-known in romance languages, the Old Portuguese camisa (shirt) was from the Late Latin camisia (shirt), from Transalpine Gaulish (of Germanic origin) from the Proto-Germanic hamiþiją (clothes, shirt, skirt), from the primitive Indo-European ḱam- (cover, clothes).  The modern use meaning a “sleeveless undergarment for women” dates from circa 1900 but for most of the late nineteen the century it generally meant "straitjacket” (a restraint for lunatics). Camisole is a noun & verb and camisoled is a verb & adjective; the noun plural is camisoles.

Camisole de force: The straitjacket

Crooked Hillary Clinton in Camisole de force (digitally altered photo).

Although ad-hoc wearable physical restraints had existed long before, the camisole de force (straitjacket) was invented circa 1772 by Irish doctor David MacBride (1726-1778), the more romantic story of it being a creation of a Monsieur Guilleret, a tapestry maker at Bicêtre Hospital, apparently a myth.  The basic concept endures to this day although they are now less used, having largely been supplanted by camisoles chimiques (or neuroleptics (a class of psychotropic drugs used to treat psychosis)).  The only fundamental change in design is that modern camisoles de force are made with sleeves, the early types restraining the arms directly under the fabric were found to be most uncomfortable.

Camisole de force on the catwalk: Straitjacket chic by Gucci and others.

Catwalks were once a place where fashion existed for fashion's sake and while there could be social or political implications in what was worn, the messaging usually had to be some sort of overt threat to the establishment for much of a protest to be raised.  However, we live now in more sensitive times and designers have to be aware of factors as diverse as religion, ethnicity, skin color, sexual orientation, age, body mass index (BMI) and the seemingly all-encompassing "cultural appropriation".  Gucci recently had to withdraw from sale a jumper (US$890, Stg£715) after critics found it too reminiscent of blackface minstrels, the connection being the built-in half-balaclava with knitted plump red lips.  That fixed, the fashion house was then accused of cultural appropriation because one of their headpieces (US$790, Stg£635) too closely resembled a Sikh turban.   To clarify the extent of the sin, the US-based Sikh Coalition issued a statement: "The Sikh turban is not just a fashion accessory, but it's also a sacred religious article of faith."

Madness (an now unfashionable word banned in polite company; the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) recommending "mental disorder" or "psychiatric disorder") may also be on fashion's banned list after Ayesha Tan-Jones (b 1993, who is non-binary and uses they/them pronouns) staged a non-oral, verbal protest while on the catwalk (they might prefer the less exploitative "runway") in the Gucci show at Milan Fashion Week 2019.  Tan-Jones and other models were dressed in white jumpsuits for the show (and it can't be long before even the use of white is declared "problematic"), some of which used the motif of the straitjacket.  On their hands, Tan-Jones had written the words "Mental health is not fashion", clearly not accepting Gucci's rationale the designs were meant to represent "how through fashion, power is exercised over life, to eliminate self-expression".  That has some linguistic tradition because women have in the past not infrequently described demands to be fashionable as "a straitjacket" but Tan-Jones presumably would prefer the notion remain a simile rather than a publicity stunt.

Ayesha Tan-Jones on the catwalk, Milan Fashion Week, September 2019. 

After the show, Tan-Jones issued their own statement, writing "Straitjackets are a symbol of a cruel time in medicine when mental illness was not understood, and people's rights and liberties were taken away from them, while they were abused and tortured in the institution.  It is in bad taste for Gucci to use the imagery of straitjackets and outfits alluding to mental patients, while being rolled out on a conveyor belt as if a piece of factory meat."  That was followed up with another post which added they, along with some of the other models in the show, were donating to mental health charities a portion (% not mentioned) of the modeling fees paid by Gucci.  "Many of the other Gucci models who were in the show felt just as strongly as I did about this depiction of straitjackets, and without their support I would not have had the courage to walk out and peacefully protest" they said.  In response, the fashion house didn't address the substantive issued raised but did confirm straitjacket chic was just "...a statement for the fashion show and will not be sold", adding the line was intended as "...an antidote to the colourful designs in the rest of the Spring/Summer 2020 show".

Lindsay Lohan in camisole.

Bipolar

Bipolar (pronounced bahy-poh-ler)

(1) Having two poles, as the earth.

(2) Of, relating to, or found at both polar regions.

(3) Characterized by opposite extremes in opinions, nature etc.

(4) In electronics, relating to a semiconductor device, such as a transistor, that exploits the electrical characteristics of contact between two substances, one with an inherent positive charge, the other with an inherent negative charge.

(5) In electric power distribution, a power transmission line having two direct-current conductors in opposite polarity.

(6) In physics, a region of magnetic flux having two distinct poles

(7) In psychiatry, of, relating to, or having bipolar disorder (a major mood disorder that is characterized by episodes of mania and depression; once known as manic-depression.

(8) In physiology, having two poles; used especially of nerve cells in which the branches project from two usually opposite points.

(9) In geopolitics, of or relating to an international system in which two states wield most of the cultural, economic, and political influence (ie two states with hegemonies exerted over their respective spheres of influence.  The companion terms are unipolar and multipolar and all are sometimes used by analogy in fields like commerce or sporting competition to reference instances of specific dominance.

1800–1810: The construct was bi- + polar.  Pole (in this context) was from the Middle French pole & pôle, from the Latin polus, from the Ancient Greek πόλος (pólos) (axis of rotation).  The –ar suffix was from Latin -āris (of, pertaining to) and was appended to nouns to create adjectives (it came increasingly to be appended to words of non-Latin origin).  The bi- prefix came directly from the Latin bi-, from Latin bis (twice) & bīnus (double), from the Proto-Italic dwi-, from the primitive Indo-European dwi- and was one of the sequence of Latin number prefixes (uni-, bi, tri etc).  In English, it can be confusing because it can used to mean either (1) two, pair, both, duo or (2) half.  In chemistry, the use meaning half has been discontinued.  In general use, the ambiguity remains, illustrated by the use when applied to measures of duration which can variously be interpreted as “once every two periods” or “twice every period”, the classic examples of which are this like biweekly, bimonthly, and biannual.  Style guides now often suggest choosing unambiguous forms such as “fortnightly” or, where no such elegant alternative exists, spelling it out explicitly (twice a month; every two years etc).  Using semi- as a prefix can work but is imprecise although acceptable if the meaning is in other ways made clear.

In English, as a clipping (a use of the prefix as a stand-alone word) of bisexual (used as both noun & adjective), the meaning was clear and effortlessly “bi” moved from LGBTQQIAAOP slang to the general vocabulary.  Potentially misleading however is bigender, a coining of LGBTQQIAAOP activists which became linguistically necessary when gender and sex were re-assigned as separate constructs.  It’s recommended it be used as the hyphenated bi-gender (to be consistent “bi-sexual” should probably also adopt the form) lest one might ponder if a bigend is LGBTQQIAAOP slang for something (and at this point one’s mind may wander) unbeknown to one.  Additionally in engineering, a big-end bearing in an internal combustion engine is the one located “big end” of the connecting rod and attached to the crankshaft.  Mechanics may use “bigender” (pronounced big-end-ah) as slang which in oral use won’t be confused with something pronounced as by-jen-dah but if transcribed, were the latter hyphenated, there’ll be no mystified mechanics.  Bipolar is a noun & adjective and bipolarization & bipolarity are nouns; the noun plural is bipolar.  

Lindsay Lohan, following Edvard Munch's (1863–1944) The Scream (1893), rendered by Vovsoft in comicbook style.  Much art has been analysed by those seeking insight into the mental health of the artist, schizophrenia and bipolar disorder two conditions frequently identified.  

The adjective bipolar dates from 1810 in the figurative sense of "of double aspect" and was by 1859 used in the literature of anatomy (having two processes from opposite poles) to refer to nerve cells while the sometimes hyphenated noun bipolarity (state of having two poles) emerged in 1834.  The earliest known instance of the now familiar use in psychiatry as a technical term to describe what was then known as manic-depressive psychosis appears to date from 1957 in a publication by German psychiatrist Karl Leonhard (1904-1988), noted in the history of the profession for his extensive (though now mostly forgotten) classification of psychotic illnesses (a nosology (the construct being nos- + -ology, from the Ancient Greek νόσος (nosos) (disease) + -λογία (-logia) (study of), the branch of medical science dealing with the classification of diseases)) although still used in structural linguistics is the system of classification of non-verbal communication.  As the term “manic-depression” ascended the linguistic treadmill (a process accelerated by the negative connotations which attached to the word because in popular literature and films manic depressives were often characterised as psychopathic murderers or other flavours or madness) “bipolar disorder” was positioned as a preferable term, the reason being that bipolar was separated from both the connotations of “manic depression” and the two elements (“manic” & “depression”), each loaded with negative associations.  Accordingly, in 1980, bipolar disorder replaced manic-depressive psychosis in the third edition (DSM-III) of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM).  According to tracking by dictionaries, it was in the mid-1990s that bipolar (in the context of mental health) gained traction in general use and, inevitably, appeared on the linguistic treadmill although even forty-odd years on there’s little to suggest it has yet reached the level of opprobrium which might prompt the DSM’s editorial board to discuss the need for a replacement although their processes can take a while, the term “mental retardation” (long regarded in the community as offensive and in some cases misleading) not replaced by term “intellectual development disorder (intellectual disability)” until the release of DSM-5-TR (text revision) in 2022.

The bipolar world in 1980.  The geopolitical architecture of the Cold War (circa 1948-circa 1990) revolved around Moscow (the Warsaw Pact) and Washington DC (NATO).

Bipolar disorder was actually introduced to the DSM when the multi-axial system (Axis I to Axis V) was created:

Axis I: Clinical Disorders (including bipolar disorder)

Axis II: Personality Disorders and Mental Retardation

Axis III: General Medical Conditions

Axis IV: Psychosocial and Environmental Problems (stressors)

Axis V: Global Assessment of Functioning

This structure was modified with the release of DSM-IV-TR (2000) which, within the axis system, divided diagnoses and symptoms into sections or "decision trees," including which symptoms must be included for a diagnosis and which must not be present.  The sectional approach was carried over to the DSM-5 (2013) when the axis system was abandoned, replaced by 20 chapters containing categories of related disorders of which “Bipolar and Related Disorders” is one, others including Anxiety disorders, Obsessive-compulsive and related disorders, Depressive disorders, Feeding and eating disorders and Personality disorders.  Within its category, bipolar disorder was subject to some refinements, including those reflected in other areas (such as objectum sexuality) that attempted to reduce the medicalization of behaviour that although statistically aberrant, was part of the normal human condition.  Childhood bipolar disorder for example, although long well-defined and accepted as a diagnosis, was effectively rolled into a new category of depressive disorders called disruptive mood dysregulation disorder (DMDD), reflecting the concern that the diagnosis of pediatric bipolar disorder was being inconsistently and overly applied to behaviour better understood as variations of childhood irritability.  Possibly too, the editors may have been influenced by work in labelling theory which suggested the early appearance in an individual’s medical history of conditions such as depression or bipolar disorder could have life-long consequences.

In the DSM-5, the diagnostic sub-categories of bipolar disorder were extended to seven:

(1) Bipolar I disorder

(2) Bipolar II disorder

(3) Cyclothymic disorder

(4) Substance/medication-induced bipolar and related disorder

(5) Bipolar and related disorder due to another medical condition

(6) Other specified bipolar and related disorder

(7) Unspecified bipolar and related disorder

Other changes included (1) the elimination of “mixed episode”.  Instead, a manic, hypomanic, or depressive episode can be specified as “with mixed features” a specifier with its own DSM definition. (2) The bipolar II diagnosis in the DSM-IV (1994) excluded a history of mixed episodes and this exclusion has been removed, something many long advocated. (3) There was a standardization of the text.  The word “abnormally” was not included in the DSM-IV criterion A for a hypomanic episode, while it was in criterion A for a manic episode; in DSM-5 the same language is used for both, the full criteria for the two distinct types of episodes thus closer together. (4) Each type of bipolar disorder gained specifiers (such as “with mixed features”, “with anxious distress” & “with rapid cycling”) which serve further to clarify the illness.

The DSM-5-TR was released in 2022 and among the changes were amendments to the section covering disorder.  Criterion B in bipolar I disorder was refined to make explicit that a manic episode can't be “superimposed on” (ie bolted-onto to run simultaneously with) an existing diagnosis of schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified psychotic disorder.  A similar procedural clarification was made to criterion C for bipolar II.  The specifiers indicating the severity of a manic episode were also updated.  Under DSM-5, the bipolar severity specifiers were mild, moderate, and severe which certainly made sense when labeling depressive episodes but when of clinical significance, that was less helpful when categorizing manic episodes because, in the nomenclature of the DSM, “mild” indicated “no impairment in functioning” whereas manic episodes inherently impaired function.  The specifiers for manic episodes accordingly were updated in the DSM-5-TR to (1) Mild (the manic episode meets the minimum symptom criteria), (2) Moderate (the manic episode causes a very significant increase in impairment and (3) Severe (the patient needs nearly continual supervision to prevent harm from being done to themselves and/or others).

2:365 by Kim Rask & Missy Douglas (2014), Ucki Ood, pp 400 (ISBN-100615950620).  A collection of 365 works painted in 2013 as a document of bipolar disorder.

First diagnosed with bipolar disorder at 19 while a student of art at Cambridge, Dr Missy Douglas (b 1977) in 2013 undertook for that year, each day to paint a canvas which would express her feelings at that moment.  To ensure the works reflected her condition rather than the effects of medication, during this year she went un-medicated, hoping the paintings would more accurately reflect the highs and lows of bipolarity.  When going to sleep each evening, Dr Douglas had no idea how she would feel the next morning, some days ecstatic, some days depressed.  Although the change in name to bipolar was probably helpful, Dr Douglas' experiment does illustrate why “manic depression” was so evocative of the condition.  Interestingly, on not one day was a painting not completed, not does the set include a blank canvas or one simply black or rendered otherwise monochromatically.  What this indicates would be something to ponder but is perhaps indicative of how a spectrum condition can manifest, Dr Douglas presumably a high-functioning bipolar.  For a BBC piece, Dr Douglas provided brief notes for six of the works:

Day 5: “I was really anxious, angry and feeling trapped.”

Day 177: “I was really in a dark place here. I was completely in a depressive phase.”

Day 236: “I was burying feelings and my emotions were all over the place.  Very turbulent.”

Day 242: “I was at the height of mania here, but there was a massive wave of white depression heading towards me.”

Day 314: “Mania.  I was buzzing and everything was technicolor and beautiful.  I was flying and felt invincible."

Day 359: “Christmas Day 2013.  I was feeling very depressed yet I completely compartmentalised and concealed it.  The twinkly forced jollity hid the sadness.”