Showing posts sorted by relevance for query Traumatic. Sort by date Show all posts
Showing posts sorted by relevance for query Traumatic. Sort by date Show all posts

Saturday, August 10, 2024

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 τραμα (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.

Thursday, October 2, 2025

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 (mnmōn) (remembering, mindful) & μνσθαι (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 (1897-1975; 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. 

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).

Thursday, January 25, 2024

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.

Monday, November 23, 2020

Grief

Grief (pronounced greef)

(1) Acute mental suffering or distress over affliction or loss; sharp sorrow; painful regret; deep or intense sorrow or distress, associated especially with the death of someone.

(2) A cause or occasion of keen distress or sorrow.

(3) In online use (especially in gaming and dating from the late 1990s), to behave in an un-sportsmanlike way or take pleasure in antagonizing other players (used as “to grief”, “griefing” or “be griefed” etc (and vaguely similar to the verb sense of troll)); to exploit a glitch or execute an online prank that diminishes or ruins a website or other online experience for other users.

(4) In idiomatic use, as “come to grief”, to suffer disappointment, misfortune, or other trouble; to fail:

(5) In idiomatic use as “good grief”, an exclamation of dismay, surprise or relief which can be used also to convey approval or disapproval, depending on context, verbal & non-verbal.

(6) In idiomatic use, as “giving me grief”, an expression of (usually mild) annoyance.

1175-1225: From the Middle English greef & gref (hardship, suffering, pain, bodily affliction), from the Anglo-French gref, from the verb grever (afflict, burden, oppress), from the Old French grief (grave, heavy, grievous, sad), from the Vulgar Latin grevis & gravare (make heavy; cause grief), from the Latin gravis (weighty, heavy, grievous, sad) (later influenced by its antonym levis) and ultimately from primitive Indo-European gréhus, gwere & gwerə- (heavy).  The general sense of “suffering or hardship” (Emotional pain, generally arising from misfortune, significant personal loss, bereavement, misconduct of oneself or others, etc.; sorrow; sadness) evolved between the early thirteenth and fourteenth centuries; a doublet of grave.  The alternative forms were greefe & griefe, both long obsolete.  The expression “good grief” appears to date only from 1912 but has been used in historical fiction which long pre-dates the twentieth century.

The circa 1300 adjective grievous was from the Anglo-French grevous, from the Old French grevos (heavy, large, weighty; hard, difficult, toilsome) and was formed directly from grief.  The term grievous bodily harm (the famous GBH) was first used in English criminal law in 1803.  The circa 1300 noun grievance (state of being aggrieved) was from the Old French grevance (harm, injury, misfortune; trouble, suffering, agony, sorrow) from grever (to harm, to burden, be harmful to) and was first used in reference to a cause of such a condition from the late fifteenth century.  The verb is now most commonly found in the gerund-participle griefing and the derived noun griefer; the past participle is griefed and the noun plural griefs.  The related terms include grievance, grieve & grievous and grief is sometimes used as a modifier (grief-striken, grief-tourism etc).  Words which often overlap with grief include agony, anguish, bereavement, despair, discomfort, gloom, heartache, heartbreak, melancholy, misery, moroseness, mourning, pain, regret, remorse, sadness, sorrow, trouble, unhappiness, woe & worry.

The DSM-5-TR, ICD codes and Prolonged Grief Disorder (PGD)

In March 2022, the American Psychiatric Association (APA) released a revision to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 (2013)).  DSM-5-TR (text revision) includes some updated text and new references, clarifications to diagnostic criteria and updates to the ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) codes which have changed since the DSM-5 was published in 2013.  A text revision to an edition of the DSM is released when a number of changes to the text that accompanies the description of disorders and their criteria are warranted by new evidence or the need for more clarity.  The text of the DSM-5 had since 2013 received some minor corrections but DSM-5-TR is a systematic text revision based on a review of the literature of the last decade (and some re-evaluation of some earlier material).  By contrast, a new edition of the DSM is released when there are thought to have been sufficient advances in the field to support the creation, substantive revisions, and elimination of multiple diagnostic criteria sets or disorders.  There has within the profession been some discussion of the implications of this and some have suggested there’s no indication of support for the need for a DSM-6, some speculation the APA might adopt the conventions of the software industry and work instead towards a version 5.1, the first number indicating a major release, the second the agglomeration of minor revisions, a format well suited to digital editions.

New ICD-10-CM codes have been added to flag and monitor suicidal behavior and non-suicidal self-injury and these can be used without the requirement of another diagnosis and in total there are over 50 coding updates for substance intoxication, withdrawal and other disorders.  The innovation in the use of the ICD-10-CM codes relation to suicidal behavior is interesting.  It’s long been understood suicidal behavior can be a useful tracking mechanism or flag for clinical attention and these codes are now available to all clinicians without the need for a mental disorder diagnosis.  The suicidal behavior codes can be applied to individuals who have engaged in potentially self-injurious behavior with at least some intent to die as a result of the act and the evidence of intent can be explicit or inferred from the behavior or circumstances.  Many suicide attempts don’t result self-injury and the changes reflect the analysis of the statistical data which indicated the previous focus on self-harm and injury meant the extent of the disorder was in many ways underestimated.  It should mean the always interesting phenomenon of “suicide attempts” undertaken in the in absence of suicidal intent becomes better understood or at least quantified.

The new diagnosis of Prolonged Grief Disorder (PGD) has been added to the trauma- and stressor-related disorders chapter.  Noted for centuries, much recent research and clinical experience has indicated there are those who experience a persistent inability to overcome their grief for the loss of a loved one for at least a year or more, with intense yearning or preoccupation with thoughts or memories of the deceased person almost every day since the death (and it’s noted that in children and adolescents, this preoccupation may focus on the circumstances of the death), symptoms severe enough to impair day-to-day functioning.  As part of the diagnosis, the duration and severity of the bereavement reaction must clearly exceed what is expected based on standards related to the individual’s social, cultural, or religious background. This does not imply people feeling grief periodically one year or more after the loss of a loved one have the disorder but those with intense and impairing grief after one year may be considered for the diagnosis.  Prior to the fifth edition, the DSM did not distinguish between “normal” and prolonged grief but PGD may be considered an evolution given the DSM-5 did include a category of persistent complex bereavement disorder (known also as traumatic grief (TG) & complicated grief (CG)) as a “condition for further study” and the first draft of a proposal was in 2018 submitted to the DSM Steering Committee and the Review Committee on Internalizing Disorders, a white paper circulated for discussion before being approved by the Board of Trustees.

The DSM editors clearly were sensitive to suggestions the creation of prolonged grief disorder might have the effect of pathologizing grief and there has long be the criticism that psychiatry increasingly has attempted to list as disorders much that has for centuries been considered part of the “normal” human condition.  To clarity things, the editors note the diagnosis is not a medicalization of grief and the diagnosis is intended only for those individuals who meet the criteria: something dramatically different from the grief normally experienced by anyone who loses a loved one; a grief intractable and disabling in a way that typical grieving is not.  Grief continues to be thought of as something healthy but not if ongoing and it's dealt with in different ways.  In 2013 Lindsay Lohan revealed her 19 year old Maltese dog Gucci (which gained the name after chewing up a pair of prized Gucci boots) had died and to feel a form of grief is thought to be a natural reaction to the event but it shouldn't persist and in many cases it seems the best therapy to to replace the pet with another/

One internally significant technical change is also noted: there are now no unique DSM codes.  The codes that appear in DSM-5-TR are the ICD codes that are equivalent to the DSM diagnoses given the version of the manual and only ICD-10-CM codes are used because this is the version of ICD that is in effect in the United States.  Although based on the World Health Organization’s (WHO) ICD-10 codes, ICD-10-CM codes in DSM-5 (and thus DSM-5-TR) have been modified from ICD-10 for clinical use by the US Centers for Disease Control (CDC) and Prevention’s National Center for Health Statistics (NCHS) and provide the only permissible diagnostic codes for mental disorders for clinical use in the United States. In the United States, the use of ICD-10-CM codes for disorders in DSM-5-TR has been mandated by the Health Care Financing Administration (HCFA) for purposes of reimbursement under the Medicare system. Although it sounds nerdy, it’s an important advance in standardization which should improve record keeping, data collection, retrieval, and compilation of statistical information.

One change which was expected was the update to the terminology to describe gender dysphoria based on updated and more culturally sensitive language.  (1) desired gender is now experienced gender, (2) cross-sex medical procedure is now gender-affirming medical procedure” and (4)  the companion terms natal male / natal female are now individual assigned male / female at birth.  Whether these changes prove to be final remains to be seen; the whole area is one of shifting linguistic sand but what’s in DSM-5-TR reflects current thinking and the entire text of the Gender Dysphoria chapter has also been updated based on a review of the literature.

Also expected was the restructuring (again) of the diagnostic criteria of Autism, reflecting the view that Autism seems to be over diagnosed, a problem inherent in spectrum conditions.  Less anticipated was the creation of Unspecified Mood Disorder (UMD) which, ominously, does sound like the criminal charge of “unspecified offences” used in the justice systems of places like the DPRK (North Korea) but which seems to have been coined to permit clinicians some flexibility so that patients presenting with irritability, agitation and sadness (and for whom some diagnosis is clearly appropriate), don’t have to be labeled as “bipolar unspecified” or “depressive disorder unspecified’, both stigmatizing conditions, the presence of which in a medical record may have implications which last a lifetime.  It’s thus a legitimate diagnosis (which really is important to patients) to be applied until a more specific disorder is found but does raise two interesting technical points: (1) can any emo not be diagnosed UMD and (2) should all emos be diagnosed UMD?

Thursday, March 27, 2025

Dwarf

Dwarf (pronounced dwawrf)

(1) A person of abnormally small stature owing to a pathological condition, especially one suffering from cretinism or some other disease that produces disproportion or deformation of features and limbs.  In human pathology, dwarfism is usually defined, inter-alia, as an adult height less than 1.47 m (4 ft 10 in).

(2) In zoology & botany, an animal or plant much smaller than the average of its kind or species.

(3) In European folklore, a being in the form of a small, often misshapen and ugly, man, usually having magic powers.

(4) In Norse mythology, any member of a race of beings from (especially Scandinavian and other Germanic) folklore, usually depicted as having some sort of supernatural powers and being skilled in crafting and metalworking, often as short with long beards, and sometimes as clashing with elves.

(5) In astronomy, a small version of a celestial body (planet, moon, galaxy, star etc).

(6) Of unusually small stature or size; diminutive; to become stunted or smaller.

Pre 900: From the Middle English dwerf, dwergh, dwerw & dwerȝ, from the Old English dweorh & dweorg (dwarf), replacing the Middle English dwerg and ultimately from the Proto-Germanic dwergaz.  It was cognate with the Scots dwerch, the Old High German twerg & twerc (German Zwerg), the Old Norse dvergr (Swedish dvärg), the Old Frisian dwirg (West Frisian dwerch), the Middle Low German dwerch, dwarch & twerg (German & Low German Dwarg & Dwarch) and the Middle Dutch dwerch & dworch (Dutch dwerg).  The Modern English noun has undergone complex phonetic changes. The form dwarf is the regular continuation of Old English dweorg, but the plural dweorgas gave rise to dwarrows and the oblique stem dweorge which led to dwery, forms sometimes found as the nominative singular in Middle English texts and in English dialects.  Dwarf is a noun and verb, dwarfness & dwarfishness are nouns, dwarfish & dwarflike are adjectives and dwarfishly is an adverb.  The plural forms are dwarves and dwarfs.  Dwarfs was long the common plural in English but after JRR Tolkien (1892-1973) used dwarves, his influence was enough to become the standard plural form for mythological beings.  For purposes non-mythological, dwarfs remains the preferred form.

The M Word

1972 MG Midget (RWA) in British Racing Green (BRG).

Dwarf seems still to be an acceptable term to describe those with dwarfism and Little People of America (LPA), the world’s oldest and largest dwarfism support organization (which maintains an international, membership-based organization for people with dwarfism and their families) has long campaigned to abolish the use of the word “midget” in the context of short humans.  The objection to midget is associative.  It was never part of the language of medicine and it was never adopted as official term to identify people with dwarfism, but was used to label used those of short stature who were on public display for curiosity and sport, most notoriously in the so-called “freak shows”.  Calling people “midgets” is thus regarded as derogatory.  Midget remains an apparently acceptable word to use in a historic context (midget submarine, MG Midget etc) or to describe machinery (midget car racing; the Midget Mustang aerobatic sports airplane) but no new adoptions have been registered in recent years.  The LPA is also reporting some supportive gestures, noting with approval the decision of the Agricultural Marketing Service (AMS) of the US Department of Agriculture’s (USDA) to revise the nomenclature used in the US standards for grades of processed raisins by removing five references to the term “midget”.  Although obviously a historically benign use of the word, its removal was a welcome display of cultural sensitivity.

An interesting outlier however is midget wrestling, a field in which the participants are said enthusiastically to support the label, citing its long traditions and the marketing value of the brand.  Although in the late twentieth century, midget wrestling’s popularity diminished in the last decade there’s be a resurgence of interest and the sport is now a noted content provider for the streaming platforms which run live and recorded footage.  Since the 1970s, midget wrestling has included styles other than the purely technical form with routines extending from choreographed parody and slapstick performances to simulated sexual assault.  These innovations have attracted criticism and the suggesting it’s a return to the freak shows of earlier centuries but audiences in the target demographic seem appreciative and, noting the success of a number of tours and operators, Major League Wrestling in 2022 announced the creation of a midget division.

The MG Midget

Where it began: 1930 MG M-Type Midget Roadster.

The earliest cars to wear MG badge (the name originally “Morris Garages”, an operation which had the same relationship to Morris as AMG does to Mercedes-Benz (ie high-performance variants)) were tuned (and often re-bodied) editions of existing Morris models but in 1928 the 8/33 M.G Midget Sports Series M (truncated usually to “M Type” was displayed at the 1928 London Olympia Motor, series production commencing the next season.  The first of a long line of tiny roadsters, 3,232 would be made between 1929-1932 and the one in the photographs above is fitted with coachwork typical of the era: an open two-seater in the fashionable “boat-tail” style, constructed by Carbodies of Coventry using construction technique which began in aviation, the panels a mix of steel and fabric-covered plywood over an ash frame.  The fabric soft-top was stored under the rear deck along its frame, tools and a spare wheel.  In the spirit of the age, a rakish two-piece windshield was fitted and there was no provision for a heater.  Despite the minimalist accommodation, the engine was surprisingly advanced, the four-cylinder engine using a bevel-gear-driven single overhead cam turning off the vertically mounted generator, 27 horsepower at a then impressive 5400 rpm generated from a displacement of 847 cm3 (51.68 cubic inches).  A footnote in the Midget’s history is that the first exported to the US was in 1930 bought by Edsel Ford (1893–1943; president of the Ford Motor Company (FoMoCo) 1919–1943), then titular head of his father’s (Henry Ford (1863-1947)) eponymous Motor company which, by the million, built larger vehicles.

1960 Austin-Healey Sprite Mark I (top left), 1966 MG Midget Mark II (top right), 1973 MG Midget Mark III (RWA, bottom left) and 1979 MG Midget Mark IV (bottom right).

For a new generation (1961-1979) of diminutive roadsters, MG revived the Midget name last used on the M-Type. MG was by the 1950s part of British Motor Corporation (BMC (1952-1967) which later would be absorbed by the doomed British Leyland (1968–1990)) and a corporate companion marquee was Austin-Healey which between 1958-1961 produced the Sprite (known variously as the “bugeye” or “frogeye”), a small sports car, built on the familiar template of economy car underpinnings with a stylish body.  After the release of the MGA (1955-1962), MG no longer had a competitor in the low-price segment so BMC took the decision that the two companies would share the model, yet another example of the “badge engineering” which BMC pragmatically (and for a while lucratively) would exploit until the process descended into self-defeating absurdity.  When the Mark II Sprites were released in 1961 (without the distinctive headlights which were the source of the nicknames), simultaneously there was the debut of the Midget, the latter slightly more expensive and better equipped, although both remained basic roadsters in the old tradition, lacking fittings such as side windows and external door-handles.  The Sprite would continue in three versions (Mark II; 1961-1964, Mark III; 1964-1966, Mark IV 1966-1971) before, following the end of BMC’s contractual arrangement with Donald Healey (1898–1988), briefly it was sold as the Austin Sprite (1971-1972) before the name was retired and the segment was left to MG.  In the decade they’d been companion models, the pair significantly had been improved, gaining power, refinement and creature comforts (the overdue door handles and side windows part of the Mark II upgrades) but what never changed were the dimensions, the things always small, something the balanced styling tended to disguise, the compactness best appreciated when one was seen parked next to a more typically sized vehicle; the Sprite and Midget being dwarfed.

Almost 130,000 Sprites were built while Midget production (which lasted until 1980) totalled some 225,000, the most numerous being the later models (Mk III; 1966–1974: 100,246 units & 1500; 1974–1979: 81,916 units).  A decade before production ended it was already outdated but such was the charm (and lack of competition) that demand remained strong almost to the end.  The most fancied Midgets are the so-called RWA (round wheel arch) models produced between 1972-1974; these adopted the design used on the rear of the bugeyes and are considered the best looking (as well as making the use of wider rear tyres easier) but in 1974 MG had to revert to the squared-off look because the strength gain from the additional metal was necessary to support the large “rubber” bumpers added to conform with US regulations; the RWA bodywork was found to be prone to damage when the rear-impact tests were conducted.  Even before the huge bumpers unhappily had been grafted, US market cars had for some months had large rubber “buffers” bolted to the chrome bumpers, known in the US as “Dagmars” and in the UK as “Sabrinas” both names tributes to the hardly vague anatomical similarity with the two pop culture figures.  Along with the big bumpers, to comply with minimum headlight height regulations in the US, the suspension height was raised by about an inch (25 mm), something which raised the centre of gravity and thus affected the handling characteristics, something adjustments to the anti-roll bars only partially ameliorated.  Visually, the increased height was disguised by lowering curve of the front wheel arch.

Triumph Spitfire, also a midget-sized roadster

A midget (with a small “m”) dwarfed by two behemoths: A 1977 Triumph Spitfire between two Ford Super Duty F-450s heavy pick-up trucks.  At their intended purpose (carrying or towing heavy payloads) Ford’s Super Duty heavy pick-up trucks perform well but such is the consumer appeal they’re a not uncommon sight used as passenger vehicles, even in cities; they can thus be both a personal and political statement, owners delighted Ford has made pick-ups great again (MPUGA).

Adopted for the range in 1999, Ford between 1958-1981 had previously used the “Super Duty” label on three large displacement (401, 477 & 534 cubic inch (6.6, 7.8 & 8.8 litre) gas (petrol) V8s, the family one of a remarkable variety of different V8s the corporation produced during the 1950s & 1960s.  Big, heavy and low-revving, the Super Duty V8 were legendarily robust and famed for their longevity but were doomed ultimately by their prodigious thirst.  They were intended only for heavy-duty, industrial use and in that very different from the Pontiac Super Duty (SD) V8s which were high-performance units, the early versions in the 1960s optimized for drag racing while the revival the next decade was the final fling of the original muscle car era (1964-1974).  The 389 & 421 cubic inch (6.4 & 6.9 litre) versions were offered between 1960-1963 while the 455 (7.5) appeared in 1973-1974 and had it not been for the 455 SD Pontiac Firebirds in those years, the muscle car era would have been regarded as having ended in 1972.  The Watergate-era 455 SD is also a footnote in the history of environmental law because Pontiac (in a preview of Volkswagen’s later “Dieselgate”) used a device to “cheat” on emission testing being undertaken as part of the certification process.  Caught re-handed, Pontiac, guilty as sin, was compelled to remove the “cheat gear” and re-submit a vehicle for testing; that’s the reason the 1973-1974 455 SD was rated at 290 horsepower (HP) rather than the 310 of the original (and more toxic) engine.

1967 Triumph Spitfire Mark II (left) and 1972 Triumph Spitfire Mark IV (with after-market exhaust tips, right).

The Triumph Spitfire had the same relationship to the larger TR sports cars (1952-1976) as the Midget did to the MGB.  Produced in five distinct generations between 1962-1980, like the Sprite & Midget, the Spitfire featured a stylish body atop the platform of a high-volume model and for the coachwork Triumph out-sourced the job to Italy, Giovanni Michelotti (1921–1980) producing a shape which owed nothing to the little Herald (1959-1971) on which it was based.  In continuous production in five versions (Mark I; 1962–1964, Mark II; 1965–1967, Mark III; 1967–1970, Mark IV; 1970–1974 & 1500; 1974–1980), almost 315,000 were built with the later models the most popular, the some 96,000 of the 1500s sold.  Like the Midget, the Spitfire was over the years improved although the things did at least stagnate in the post-1974 US models which became heavier, slower and uglier although in the 1970s that was a general industry trend.  The Although soon under the same corporate umbrella, the Midget & Spitfire were competitors (in the showroom and on the circuits) for almost two decades and when Road & Track magazine in their September 1967 edition published a comparison test, they couldn't decide which was best, concluding: "...whichever one the buyer chooses, he is assured of many miles of motoring pleasure in the great sports car tradition.  They're good cars, both of them.  You can't go wrong."  For the readers that may not have been a great deal of help and the phrasing must have been force of habit because the two little roadsters had always enjoyed some popularity among women.  

The photograph run in 1959 with the caption “Hark the Herald’s axle’s swing” (left) and a Mark I Spitfire's swing axles displaying the same behavior.

The Spitfires of the 1960s were a bit more lively but that description wasn’t always a compliment because, based on the Herald, what was inherited was the swing-axle rear suspension and swing the axles certainly could, leading to a “lively rear”.  When the British motoring press first tested the Herald they noted the behaviour of the swing axles under extreme load and had a photographer appropriately positioned: The caption “Hark the Herald’s axle’s swing” became famous.  None of that deterred Triumph which in 1962 introduced a more powerful version powered by a 1.6 litre (97 cubic inch) straight six.  That meant a faster car which meant the behaviour of the swing axles could be experienced at a higher speed (with all that implies) but the car sold well which was encouraging so Triumph in 1966 fitted a 2.0 litre (122 cubic inch) six.  It was not until 1968 the rear suspension was revised and this curative solved the errant characteristics to a degree which impressed even the usually sceptical motoring journalists and sales remained strong until production ended in 1971.  Offered only in four-cylinder form, the revisions to the Spitfire’s rear suspension were less complex but when tested on the Mark IV in 1970, the improvement was apparent and from this point, criticism ceased of of road-holding at the limit.

1967 Triumph GT6 Mark I (also with after-market exhaust tips, left) and 1979 Triumph Spitfire 1500 (right).  With production ending in 1973, the GT6 was spared from being disfigured by the battering-ram like bumpers imposed on the Spitfire, those on the last of the line (1979-1980) the biggest.

While the roadster never gained six-cylinder power, Triumph from 1966 offered a coupé version (with a convenient hatchback, al la the Jaguar E-Type (XKE, 1961-1974) called the GT6.  Mechanically it followed the Vitesse except it was only ever fitted with the 2.0 litre engine and didn’t receive the suspension fix until the Mark II in 1969 and that transformed things although, being relatively complex it must have been deemed too expensive to justify on what proved a low-volume model and the with the release of the Mark III in 1970, a version of that used on the Spitfire was substituted and it proved just as effective.  Sales of the GT6 never matched the company’s expectation and the market preferred the MGB GT (1965-1980) which used the same concept for the body.  Noting the costs which would have been incurred to make the GT6 compliant with the US regulations to take effect from 1974, production ended in late 1973.  Because the considerably more powerful (especially the fuel-injected versions sold outside the US) 2.5 litre six Triumph used in the TR5 (which, with twin carburetors, was in North America sold as the TR-250), TR6, 2.5 PI & 2500 is a relatively easy swap, quite a few GT6s have been so upgraded although some attention does need to be paid to the chassis to achieve a completely satisfactory road car.  

The short stature of Victor Emmanuel III (1869–1947; King of Italy 1900-1946) with (left to right), with Aimone of Savoy, King of Croatia (Rome, 1943), with Albert I, King of the Belgians (France, 1915), with his wife, Princess Elena of Montenegro (Rome 1937) & with Adolf Hitler (1889-1945; Führer (leader) and German head of government 1933-1945 & head of state 1934-1945), observing the Italian navy conduct manoeuvres, Gulf of Naples, 1938.  Note the King of Italy's sometimes DPRKesque hats.

Technically, Victor Emmanuel didn’t fit the definition of dwarfism which sets a threshold of adult height at 4 feet 10 inches (1.47 m), the king about 2 inches (50 mm) taller (or less short) and it’s thought the inbreeding not uncommon among European royalty might have been a factor, both his parents and grandparents being first cousins.  However, although not technically a dwarf, that didn’t stop his detractors in Italy’s fascist government calling him (behind his back) il nano (the dwarf), a habit soon picked up the Nazis as der Zwerg (the dwarf) (although Hermann Göring (1893–1946; leading Nazi 1922-1945, Hitler's designated successor & Reichsmarschall 1940-1945) was said to have preferred der Pygmäe (the pygmy)).  In court circles he was knows also (apparently affectionately) as la piccola sciabola (the little sabre) a nickname actually literal in origin because the royal swordsmith had to forge a ceremonial sabre with an unusually short blade for the diminutive sovereign to wear with his many military uniforms.  His French-speaking wife (Princess Elena of Montenegro (1873–1952; Queen of Italy 1900-1946)) stood a statuesque six feet (1.8 m) tall and always called him mon petit roi (my little king).  It was a long and happy marriage and genetically helpful too, his son and successor (who enjoyed only a brief reign) very much taller although his was to be a tortured existence Still, in his unhappiness the scion stood tall and that would have been appreciated by the late Prince Philip, Duke of Edinburgh (1921–2021) who initially approved of the marriage of Lady Diana Spencer (1960-1997) to the Prince of Wales (b 1948) on the basis that she “would breed some height into the line”.

In cosmology, the word dwarf is applied to especially small versions of celestial bodies.  A dwarf galaxy is a small galaxy of between several hundred and several billion stars, (the Milky Way may have as many as billion) and astronomers have identified many sub-types of dwarf galaxies, based on shape and composition.  A dwarf planet is a small, planetary-mass object is in direct orbit of a star, smaller than any of the eight classical planets but still a world in its own right.  Best-known dwarf planet is now Pluto which used to be a planet proper but was in 2006 unfortunately down-graded by the humorless types at the International Astronomical Union (IAU) who are in charge of such things.  It’s hoped one day this decision will be reversed so Pluto will again be classified a planet.  Dwarf planets are of interest to planetary geologists because despite their size, they may be geologically active bodies.  The term dwarf star was coined when it was realized the reddest stars could be classified as brighter or dimmer than our sun and they were created the categories “giant star” (brighter) and dwarf star (dimmer).  As observational astronomy improved, the

With the development of infrared astronomy there were refinements to the model to include (1) the dwarf star (the “generic” main-sequence star), (2) the red dwarf (low-mass main-sequence star), (3) the yellow dwarfs are (main-sequence stars with masses comparable to that of the Sun, (4) the orange dwarf (between a red dwarf and yellow/white stars), (5) the controversial blue dwarf which is a hypothesized class of very-low-mass stars that increase in temperature as they near the end of their main-sequence lifetime, (6) the white dwarf which is the remains of a dead star, composed of electron-degenerate matter and thought to be the final stage in the evolution of stars not massive enough to collapse into a neutron star or black hole, (7) the black dwarf which is theorized as a white dwarf that has cooled to the point it no longer emits visible light (it’s thought the universe is not old enough for any white dwarf to have yet cooled to black & (8) the brown dwarf, a sub-stellar object not massive enough to ever fuse hydrogen into helium, but still massive enough to fuse deuterium.

Coolest dwarf of all is (9) the ultra-cool dwarf (first defined in 1997), somewhat deceptively named for non cosmologists given the effective temperature can be as high as 2,700 K (2,430°C; 4,400°F); in space, everything is relative.  Because of their slow hydrogen fusion compared to other types of low-mass stars, their life spans are estimated at several hundred billion years, with the smallest lasting for about 12 trillion years.  As the age of the universe is thought to be only 13.8 billion years, all ultra-cool dwarf stars are relatively young and models predict that at the ends of their lives the smallest of these stars will become blue dwarfs instead of expanding into red giants.

Disney's seven dwarfs; they're now cancelled.

The events towards the conclusion of the nineteenth century German fairy tale Snow White and the Seven Dwarfs make ideal reading for young children.  Her evil step-mother has apparently killed poor Snow White so the seven disappointed dwarfs lay her body in a glass coffin.  The very next, a handsome prince happens upon the dwarfs’ house in the forest and is so captivated by her beauty he asks to take her body back to his castle.  To this the dwarfs agree but while on the journey, a slight jolt makes Snow White come to life and the prince, hopelessly in love, proposes and Snow White accepts.  Back at the palace, the prince invites to the wedding all in the land except Snow White's evil stepmother.

Snow White and the Seven Dwarfs, even Happy looking sad.

The step-mother however crashes the wedding and discovers the beautiful Snow White is the bride.  Enraged, she again attempts murder but the prince protects her and, learning the truth from his bride, forces the step-mother to wear a pair of red-hot iron slippers and dance in them until she dies; that takes not long and once she has the decency to drop dead, the nuptials resume.  In the way things happen in fairy tales, the prince and Snow White live happily ever after.

DEI (diversity, equity and inclusion)

The condition achondroplasiaphobia describes those with a “fear of little people".  The construct is achondroplasia (the Latin a- (not) +‎ the Ancient Greek chondro- (cartilage) + the New Latin‎ -plasia (growth); the genetic disorder that causes dwarfism) + phobia (from the New Latin, from the Classical Latin, from the Ancient Greek -φοβία (-phobía) from φόβος (phóbos) (fear).  The condition, at least to the extent of being clinically significant, is thought rare and like many of the especially irrational phobias is induced either by (1) a traumatic experience, (2) depictions in popular culture or (3) reasons unknown.  Achondroplasiaphobia has never appeared in the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM).  In 2006, it was reported that while dining at the Chateau Marmont hotel in Los Angeles, after noticing two people of short stature had entered the restaurant, Lindsay Lohan suffered an "anxiety attack" and hyperventilated to the extent she had to take "an anti-anxiety pill" to calm down.  To her companions she repeatedly said "I’m so scared of them!"  A spokesperson for the LPA responded by suggesting Ms Lohan should "...treat her fear the same as she would a fear of any other protected minority population.  If that fails, she might find diversity training to be useful."  Almost immediately the story appeared, it was debunked by a representative for Ms Lohan who issued a statement  saying she is not achondroplasiaphobic and not in any way scared of little people, adding "Lindsay loves all people."

Prince Charming's non-consensual kiss of Snow White on her "lips red as blood".

In February 2025, Luis Rubiales (b 1977), the former president of the Royal Spanish Football Federation was found guilty of sexual assault for kissing player Jenni Hermoso (b 1990) without her consent and was fined €10,800 so, at least in some jurisdictions, the matter of consenting to a kiss is not mere legal theory.

Among critics and industry analysts, the consensus seem to be that in late 1919 when the project was approved, for Disney to allocate a budget of US$200 million (it ended up being booked at around US$250 million) to a remake of Snow White and the Seven Dwarfs (1937) probably was a good idea.  Based on the German fairy tale Sneewittchen which first appeared in print early in the nineteenth century, Disney’s 1937 production was the first animated, full-length feature film made in the US and it was both critically acclaimed and a great commercial success, becoming the highest-grossing film of 1938; adjusted for inflation, it’s success then and since has made it one of the most profitable films ever made.

The elements in its success were (1) the quality of the studio’s work, (2) advances in the technology delivering sight and sound which made the audience's experience so vivid and (3) the threads of the story which are fairy tale classics: A wicked queen, jealous of her stepdaughter’s beauty orders her murder, only to discover she’s hiding out in a cottage with seven dwarves so she poisons her with an adulterated apple, inducing a deep sleep from which she eventually is awoken by the kiss of a handsome prince.  In 1937, had the word “problematic” then been in use, it wouldn't have been applied to anything in the plot but by the early 2020s, things had changed.  In the pre Trump 2.0 era, when DEI (diversity, equity & inclusion) was compulsory, having Snow White gaining her name because her skin was as “white as snow” and the very existence of dwarfs were both definitely “problematic” so the challenge was to keep the “Snow White” in the title while changing troublesome content as required.  That's been done before and had the 2024 US presidential election elected someone (probably anyone) else, Snow White could have appeared in cinemas to lukewarm reviews but a solid box office based on 7-11 year old girls still impressed at Meghan Markle (Meghan, Duchess of Sussex; b 1981) having proved its not only in fairy tales that princes rescue middle-class girls from dreary lives.  Only Fox News would much have bothered with a condemnation.

Times have changed.  Whether it's Snow White or Sleeping Beauty, for a man (whether or not a prince) to kiss an unresponsive female, it's now usually some sort of assault.  An unresponsive female cannot grant consent.

So for Disney, the timing of events was unfortunate but the earlier race and cultural controversies which swirled around the earlier remakes of Mulan (2020) and The Little Mermaid (2023) should have been a warning.  Most jarring perhaps was the absence of “dwarfs” (in the historic sense of the word).  While Snow White is of course the protagonist, in casting terms there was only one of her and seven of them so the substitution of the heptad with “magical creatures” was always going to attract a critique of its own.  According to the studio, it consulted members of the dwarfism community (the so-called “little people”) “to avoid reinforcing stereotypes” before the re-casting but, given the production was, according to many, replete with cultural, sexist and chauvinist tropes, the cancelled dwarfs received less attention than might have been expected.  With reviewers using phrases like “exhaustingly awful reboot” and “tiresome pseudo-progressive additions”, expectations of success for Snow White have been lowered.