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Sunday, September 10, 2023

Oedipus complex

From Wikipedia, the free encyclopedia
Oedipus describes the riddle of the Sphinx by Jean-Auguste-Dominique Ingres, c. 1805

In classical psychoanalytic theory, the term Oedipus complex (also spelled Œdipus complex) refers to a son's sexual attitude towards his mother and concomitant hostility toward his father, first formed during the phallic stage of psychosexual development. A daughter's attitude of desire for her father and hostility toward her mother is referred to as the feminine Oedipus complex. The general concept was considered by Sigmund Freud in The Interpretation of Dreams (1899), although the term itself was introduced in his paper A Special Type of Choice of Object made by Men (1910).

Freud's ideas of castration anxiety and penis envy refer to the differences of the sexes in their experience of the Oedipus complex. The complex is thought to persist into adulthood as an unconscious psychic structure which can assist in social adaptation but also be the cause of neurosis. According to sexual difference, a positive Oedipus complex refers to the child's sexual desire for the opposite-sex parent and aversion to the same-sex parent, while a negative Oedipus complex refers to the desire for the same-sex parent and aversion to the opposite-sex parent. Freud considered that the child's identification with the same-sex parent is the socially acceptable outcome of the complex. Failure to move on from the compulsion to satisfy a basic desire and to reconcile with the same-sex parent leads to neurosis.

The theory is named for the mythological figure Oedipus, an ancient Theban King who discovers he has unknowingly murdered his father and married his mother, whose depiction in Sophocles' Oedipus Rex had a profound influence on Freud. Freud rejected the term Electra complex, introduced by Carl Jung in 1913 as a proposed equivalent complex among young girls.

Some critics have argued that Freud, by abandoning his earlier seduction theory (which attributed neurosis to childhood sexual abuse) and replacing it with the theory of the Oedipus complex, instigated a cover-up for sexual abuse of children. Some scholars and psychologists have criticized the theory for being incapable of applying to same-sex parents, and as being incompatible with the widespread aversion to incest.

Background

Sigmund Freud (age 16) with his mother in 1872

Oedipus refers to a 5th-century BC Greek mythological character Oedipus, who unwittingly kills his father, Laius, and marries his mother, Jocasta. A play based on the myth, Oedipus Rex, was written by Sophocles, ca. 429 BC.

Modern productions of Sophocles' play were staged in Paris and Vienna in the 19th century and were phenomenally successful in the 1880s and 1890s. The Austrian neurologist Sigmund Freud (1856–1939) attended. In his book The Interpretation of Dreams, first published in 1899, he proposes that an Oedipal desire is a universal psychological phenomenon innate (phylogenetic) to human beings, and the cause of much unconscious guilt.

Freud believed that the Oedipal sentiment has been inherited through the millions of years it took for humans to evolve from apes. His view of its universality was based on his clinical observation of neurotic or normal children, his analysis of his own response to Oedipus Rex, and on the fact that the play was effective on both ancient and modern audiences. Freud describes the Oedipus myth's timeless appeal thus:

His destiny moves us only because it might have been ours — because the Oracle laid the same curse upon us before our birth as upon him. It is the fate of all of us, perhaps, to direct our first sexual impulse towards our mother and our first hatred and our first murderous wish against our father. Our dreams convince us that this is so.

Freud also claims that the play Hamlet "has its roots in the same soil as Oedipus Rex", and that the differences between the two plays are revealing:

In [Oedipus Rex] the child's wishful fantasy that underlies it is brought into the open and realized as it would be in a dream. In Hamlet it remains repressed; and—just as in the case of a neurosis—we only learn of its existence from its inhibiting consequences.

However, in The Interpretation of Dreams, Freud makes it clear that the "primordial urges and fears" that are his concern and the basis of the Oedipal complex are inherent in the myths the play is based on, not primarily in the play itself, which Freud refers to as a "further modification of the legend" that originates in a "misconceived secondary revision of the material, which has sought to exploit it for theological purposes".

Before the idea of the Oedipus complex, Freud believed that childhood sexual trauma was the cause of neurosis. This idea, sometimes called Freud's seduction theory, was deemphasized in favor of the Oedipus complex around 1897.

Timeline

  • 1896. Freud publishes The Aetiology of Hysteria. The paper was criticized for theorizing that hysteria is caused by sexual abuse.
  • 1897–1909. After his father's death in 1896, and having seen the play Oedipus Rex, by Sophocles, Freud begins using the term "Oedipus". As Freud wrote in an 1897 letter, "I found in myself a constant love for my mother, and jealousy of my father. I now consider this to be a universal event in early childhood."
  • 1909–1914. Proposes that Oedipal desire is the "nuclear complex" of all neuroses; first usage of "Oedipus complex" in 1910.
  • 1914–1918. Considers paternal and maternal incest.
  • 1919–1926. Complete Oedipus complex; identification and bisexuality are conceptually evident in later works.
  • 1926–1931. Applies the Oedipal theory to religion and custom.
  • 1931–1938. Investigates the "feminine Oedipus attitude" and "negative Oedipus complex"; later the "Electra complex".

The Oedipus complex

Original formulation

Freud's original examples of the Oedipus complex are applied only to boys or men; he never fully clarified his views on the nature of the complex in girls. He described the complex as a young boy's hatred or desire to eliminate his father and to have sex with his mother.

Freud introduced the term "Oedipus complex" in a 1910 article titled A Special Type of Choice of Object made by Men. It appears in a section of this paper describing what happens after a boy first becomes aware of prostitution:

When after this he can no longer maintain the doubt which makes his parents an exception to the universal and odious norms of sexual activity, he tells himself with cynical logic that the difference between his mother and a whore is not after all so very great, since basically they do the same thing. The enlightening information he has received has in fact awakened the memory-traces of the impressions and wishes of his early infancy, and these have led to a reactivation in him of certain mental impulses. He begins to desire his mother herself in the sense with which he has recently become acquainted, and to hate his father anew as a rival who stands in the way of this wish; he comes, as we say, under the dominance of the Oedipus complex. He does not forgive his mother for having granted the favour of sexual intercourse not to himself but to his father, and he regards it as an act of unfaithfulness.

Freud and others eventually extended this idea and embedded it in a larger body of theory.

Later theory

Oedipus and the Sphinx, by Gustave Moreau (1864)

In classical psychoanalytic theory, the Oedipus complex occurs during the phallic stage of psychosexual development (age 3–6 years), although it can manifest at an earlier age.

In the phallic stage, a boy's decisive psychosexual experience is the Oedipus complex—his son–father competition for possession of his mother. It is in this third stage of psychosexual development that the child's genitalia is his or her primary erogenous zone; thus, when children become aware of their bodies, the bodies of other children, and the bodies of their parents, they gratify physical curiosity by undressing and exploring themselves, each other, and their genitals, so learning the anatomic differences between male and female and the gender differences between boy and girl.

Despite the mother being the parent who primarily gratifies the child's desires, the child begins forming a discrete sexual identity—"boy", "girl"—that alters the dynamics of the parent and child relationship; the parents become objects of infantile libidinal energy. The boy directs his libido (sexual desire) toward his mother and directs jealousy and emotional rivalry against his father. The boy's desire for his mother is concomitant with a desire for the death of his father and even an impulse to instigate that death. These desires manifest in the realm of the id, governed by the pleasure principle, but the pragmatic ego, governed by the reality principle, knows that the father is an impossible rival to overcome and the impulse is repressed. The boy's ambivalence about his father's place in the family, is manifested as fear of castration by the physically superior father; the fear is an irrational, subconscious manifestation of the infantile id.

In both sexes, defense mechanisms provide transitory resolutions of the conflict between the drives of the id and the drives of the ego. Repression, the blocking of unacceptable ideas and impulses from the conscious mind, is the first defence mechanism, but its action does not resolve the id–ego conflict; it merely confines the impulse in the unconscious, where it continues to exert pressure in the direction of consciousness. The second defense mechanism is identification, in which the child adapts by incorporating, into his or her (super)ego, the personality characteristics of the same-sex parent. In the case of the boy, this diminishes his castration anxiety, because his likeness to his father protects him from the consequences of their rivalry. The little girl's anxiety is diminished in her identification with the mother, who understands that neither of them possesses a penis, and thus are not antagonists.

The satisfactory resolution of the Oedipus complex is considered important in developing the male infantile super-ego. By identifying with the father, the boy internalizes social morality, thereby potentially becoming a voluntary, self-regulating follower of societal rules, rather than merely reflexively complying out of fear of punishment. Unresolved son–father competition for the psychosexual possession of the mother might result in a phallic stage fixation that leads to the boy becoming an aggressive, over-ambitious, and vain man.

Oedipal case study

In Analysis of a Phobia in a Five-year-old Boy (1909), the case study of the equinophobic boy "Little Hans", Freud showed that the relation between Hans's fears—of horses and of his father—derived from external factors, the birth of a sister, and internal factors, the desire of the infantile id to replace his father as companion to his mother, and guilt for enjoying the masturbation normal to a boy of his age. Little Hans himself was unable to relate his fear of horses to his fear of his father. As the treating psychoanalyst, Freud noted that "Hans had to be told many things that he could not say himself" and that "he had to be presented with thoughts, which he had, so far, shown no signs of possessing".

Feminine Oedipus attitude

Freud applied the Oedipus complex to the psychosexual development of boys and girls, but later modified the female aspects of the theory as "feminine Oedipus attitude" and "negative Oedipus complex". His student–collaborator Carl Jung, in his 1913 work The Theory of Psychoanalysis, proposed the Electra complex to describe a girl's daughter–mother competition for psychosexual possession of the father.

In the phallic stage, the feminine Oedipus attitude is the little girl's decisive psychodynamic experience in forming a discrete sexual identity (ego). Whereas a boy develops castration anxiety, a girl develops penis envy, for she perceives that she has been castrated previously (and missing the penis), and so forms resentment towards her own kind as inferior, while simultaneously striving to claim her father's penis through bearing a male child of her own. Furthermore, after the phallic stage, the girl's psychosexual development includes transferring her primary erogenous zone from the infantile clitoris to the adult vagina.

Freud considered a girl's negative Oedipus complex to be more emotionally intense than that of a boy, resulting, potentially, in a woman of submissive, insecure personality.

Freudian theoretic revision

Carl Gustav Jung

The Electra complex: the matricides Electra and Orestes.

In response to Freud's proposal of the Oedipus complex, which was initially more focused on the little boy's experience of desire for the mother and jealous rivalry in relation of the father, student–collaborator Carl Jung proposed that girls experienced desire for the father and aggression towards the mother via what he called the Electra complex. Electra was a Greek mythologic figure who plotted matricidal revenge with Orestes, her brother, against their mother Clytemnestra and their stepfather Aegisthus, for the murder of her father Agamemnon. Like Oedipus, the character is the subject of a play by Sophocles (Electra) from the 5th century BC. Orthodox Jungian psychology uses the term "Oedipus complex" only to denote a boy's psychosexual development. Freud himself rejected the equivalence, arguing that at this stage of development it is only the male who experiences a simultaneous love for one parent and competitive hatred for the other. For Freud, the idea of the Electra complex assumes an analogous relation between boys and girls, in relation to their same and opposite sex parents, that does not actually exist. According to Freud, the Electra complex fails to take account of the differing effects of the castration complex, and the significance of the phallus, in the two sexes, and overlooks the girl's preoedipal attachment to the mother.

Otto Rank

Otto Rank on the far left, behind Sigmund Freud, and other psychoanalysts (1922).

In classical Freudian psychology the super-ego, "the heir to the Oedipus complex", is formed as the infant boy internalizes the familial rules of his father. In contrast, in the early 1920s, using the term "pre-Oedipal", Otto Rank proposed that a boy's powerful mother was the source of the super-ego, in the course of normal psychosexual development. Rank's theoretic conflict with Freud excluded him from the Freudian inner circle; nonetheless, he later developed the psychodynamic Object relations theory in 1925.

Melanie Klein

Whereas Freud proposed that the father (the paternal phallus) was central to infantile and adult psychosexual development, Melanie Klein concentrated on the early maternal relationship, proposing that Oedipal manifestations are perceptible in the first year of life, the oral stage. Her proposal was part of the "controversial discussions" (1942–44) at the British Psychoanalytical Association. The Kleinian psychologists proposed that "underlying the Oedipus complex, as Freud described it ... there is an earlier layer of more primitive relationships with the Oedipal couple". She assigned "dangerous destructive tendencies not just to the father but also to the mother in her discussion of the child's projective fantasies". Klein's concept of the depressive position, resulting from the infant's ambivalence toward the mother, lessened the central importance of the Oedipus complex in psychosexual development.

Wilfred Bion

"For the post-Kleinian Bion, the myth of Oedipus concerns investigatory curiosity—the quest for knowledge—rather than sexual difference; the other main character in the Oedipal drama becomes Tiresias (the false hypothesis erected against anxiety about a new theory)". As a result, "Bion regarded the central crime of Oedipus as his insistence on knowing the truth at all costs".

Jacques Lacan

Jacques Lacan argued against removing the Oedipus complex from the center of psychosexual developmental experience. For him, the Oedipus complex "—in so far as we continue to recognize it as covering the whole field of our experience with its signification—may be said to mark the limits that our discipline assigns to subjectivity". It is that which superimposes the kingdom of culture upon the person, marking his or her introduction to the symbolic order.

Thus "a child learns what power independent of itself is as it goes through the Oedipus complex ... encountering the existence of a symbolic system independent of itself". Moreover, Lacan's proposal that "the ternary relation of the Oedipus complex" liberates the "prisoner of the dual relationship" of the son–mother relationship proved useful to later psychoanalysts; thus, for Bollas, the "achievement" of the Oedipus complex is that the "child comes to understand something about the oddity of possessing one's own mind ... discovers the multiplicity of points of view". Likewise, for Ronald Britton, "if the link between the parents perceived in love and hate can be tolerated in the child's mind ... this provides us with a capacity for seeing us in interaction with others, and ... for reflecting on ourselves, whilst being ourselves". As such, in The Dove that Returns, the Dove that Vanishes (2000), Michael Parsons proposed that such a perspective permits viewing "the Oedipus complex as a life-long developmental challenge ... [with] new kinds of Oedipal configurations that belong to later life".

In 1920, Sigmund Freud wrote that "with the progress of psychoanalytic studies the importance of the Oedipus complex has become, more and more, clearly evident; its recognition has become the shibboleth that distinguishes the adherents of psychoanalysis from its opponents"; thereby it remained a theoretic cornerstone of psychoanalysis until about 1930, when psychoanalysts began investigating the pre-Oedipal son–mother relationship within the theory of psychosexual development. Janet Malcolm reports that by the late 20th century, to the object relations psychology "avant-garde, the events of the Oedipal period are pallid and inconsequential, in comparison with the cliff-hanging psychodramas of infancy. ... For Kohut, as for Winnicott and Balint, the Oedipus complex is an irrelevance in the treatment of severe pathology". Nonetheless, ego psychology continued to maintain that "the Oedipal period—roughly three-and-a-half to six years—is like Lorenz standing in front of the chick, it is the most formative, significant, moulding experience of human life ... If you take a person's adult life—his love, his work, his hobbies, his ambitions—they all point back to the Oedipus complex".

Criticism

Lack of empirical basis

Studies conducted of children's attitudes to parents at the oedipal stage do not demonstrate the shifts in positive feelings that are predicted by the theory. Case studies that Freud relied upon, such as the case of Little Hans, could not be verified through research or experimentation on a larger population. Adolf Grünbaum argues that the type of evidence Freud and his followers used, the clinical productions of patients during analytic treatment, by their nature cannot provide cogent observational support for Freud's core hypotheses.

Evolutionary psychologists Martin Daly and Margo Wilson, in their 1988 book Homicide, argue that the Oedipus complex theory yields few testable predictions. They find no evidence of the Oedipus complex in people. There is evidence of parent–child conflict but it is not for sexual possession of the opposite sex-parent.

According to psychiatrist Jeffrey Lieberman, Freud and his followers resisted subjecting his theories, including the Oedipus theory, to scientific testing and verification. Lieberman claims that investigations based in cognitive psychology either contradict or fail to support Freud's ideas.

Cover for sexual abuse

In the 1970s, social worker Florence Rush wrote that Freud's seduction theory, which came early in his career, correctly attributed his patients' memories of childhood trauma to the patient's family, often the father, implying that widespread sexual abuse of children by parents was common in his society. According to Rush, the discovery of this abuse made Freud uncomfortable, so he abandoned the theory and invented the Oedipus complex to replace it. The Oedipus complex allowed him to attribute stories of childhood sexual abuse to the children themselves. Freud came to the conclusion that the stories were fantasies of hidden desires, rather than factual descriptions of trauma. Thus, Rush argues, Freud covered up illegal and immoral sexual abuse by undermining the perceptions of his patients, particularly his female patients. Rush's theory became known as The Freudian Coverup.

A director of the Sigmund Freud Archives, Jeffrey Moussaieff Masson, adopted the view that Freud's work was a cover-up for abuse after reading Freud's unpublished letters. In his book The Assault on Truth, Masson argues that Freud misattributed accounts of sexual abuse to fabrications and fantasies of children because, for personal reasons, he was unable to accept that the accounts were real. According to Masson, among Freud's reasons to suppress the abuse was that he did not want to be confronted by the father of a patient who was accused of committing abuse. Late in his career Freud sought to prevent colleague Sandor Ferenczi from delivering a paper that reasserted the seduction theory. Freud had hoped that his former student would abandon the theory as he himself had done, but Ferenczi delivered the paper in 1932. Masson writes that, because the theory of the Oedipus complex became widely popular, psychoanalysts continue to do damage to their patients by doubting the reality of the patient's early memories of trauma.

Other Freud scholars argue that Masson and Rush have misrepresented the reasons and intention behind Freud's abandonment of the seduction theory and adoption of the theory of the Oedipus complex. According to Dr. Kurt R. Eissler, who replaced Masson as director of the Freud Archives, Freud did not in any sense reject the reality of childhood sexual trauma, but realized that actual abuse was not the universal cause of neurosis he had thought it to be. New York psychiatrist Dr. Frank R. Hartmann said that "Freud realized he made a mistake in attributing all neurosis to repressed memories of actual abuse. He discovered a much broader theory which explained much more." The historian Peter Gay, author of Freud: A Life for Our Time (1988), emphasizes that Freud continued to believe that some patients were sexually abused, but realized that there can be a difficulty in distinguishing between truth and fiction. Therefore, according to Gay, there was no sinister motive in changing his theory; Freud was a scientist seeking the facts and was entitled to change his views if new evidence was presented to him.

Gender role assumptions

Many scholars and psychologists observe that, because the theory of the Oedipus complex assigns distinct roles to a mother and father, it is a poor fit for families that do not use traditional gender roles.

The Oedipus complex has been criticized for disregarding nontraditional family structures such as families with parents of the same sex

As of November 2022 same-sex marriage is legal in 31 nations. Same-sex couples start families through adoption or surrogacy. The pillars of the family structure are diversifying to include parents who are single or of the same sex as their partner along with the traditional heterosexual, married parents. These new family structures pose new questions for the psychoanalytic theories such as the Oedipus complex that require the presence of the mother and the father in the successful development of a child.

Evidence suggests children who have been raised by parents of the same sex are not much different from children raised in a traditional family structure. The classic theory of the Oedipal drama has fallen out of favor in today's society, according to a study by Drescher, having been criticized for its "negative implications" towards same sex parents. Many psychoanalytic thinkers such as Chodorow and Corbett are working towards changing the Oedipus complex to eliminate "automatic associations among sex, gender, and the stereotypical psychological functions deriving from these categories" and make it applicable to today's modern society. From its Freudian conception, psychoanalysis and its theories have always relied on traditional gender roles to draw itself out.

In the 1950s, psychologists distinguished different roles in parenting for the mother and father. The role of primary caregiver is assigned to the mother. Motherly love was considered to be unconditional. While the father is assigned the role of secondary caregiver, fatherly love is conditional, responsive to the child's tangible achievements. The Oedipus complex is compromised in the context of modern family structures, as it requires the existence of the notions of masculinity and femininity. When there is no father present there is no reason for a boy to have castration anxiety and thus resolve the complex. Psychoanalysis presents non-heteronormative relationships a sort of perversion or fetish rather than a natural occurrence. To some psychologists, this emphasis on gender norms can be a distraction in treating homosexual patients.

The 1972 book Anti-Oedipus by Gilles Deleuze and Félix Guattari is "a critique of psychoanalytic normativity and Oedipus" according to Didier Eribon. Eribon criticizes the Oedipus complex described by Freud or Lacan as an "implausible ideological construct" which is an "inferiorization process of homosexuality". According to psychologist Geva Shenkman, "To examine the application of concepts such as Oedipus complex and primal scene to male same-sex families, we must first eliminate the automatic associations among sex, gender, and the stereotypical psychological functions based on these categories."

Postmodern psychoanalytic theories, which aim to reestablish psychoanalysis for modern times, suggest modifying or discarding the complex because it does not describe newer family structures. Shenkman suggests that a loose interpretation of the Oedipus complex in which the child seeks sexual satisfaction from any parent regardless of gender or sex, would be helpful: "From this perspective, any parental authority, or institution for that matter, may represent the taboo that gives rise to the complex". Psychoanalyst Melanie Klein proposed a theory which broke gender stereotypes but still kept traditional father-mother family structure. She assigned "dangerous destructive tendencies not just to the father but also to the mother in her discussion of the child's projective fantasies".

Stretched theory

Anouchka Grose understands the Oedipus complex as "a way of explaining how human beings are socialised ... learning to deal with disappointment". Her summary of the complex is "You have to stop trying to be everything for your primary carer, and get on with being something for the rest of the world". This post-Lacanian interpretation of the complex diverges considerably from its description in 19th century. Eribon writes that it "stretches the Oedipus complex to a point where it almost doesn't look like Freud's any more".

Aversion to incest

Parent-child and sibling-sibling incestuous unions are almost universally forbidden. An explanation for this incest taboo is that rather than instinctual sexual desire, there is instinctual sexual aversion against these unions (See Westermarck effect). Steven Pinker wrote that "The idea that boys want to sleep with their mothers strikes most men as the silliest thing they have ever heard. Obviously, it did not seem so to Freud, who wrote that as a boy he once had an erotic reaction to watching his mother dressing. Of note is that Amalia Nathansohn Freud was relatively young during Freud's childhood and thus of reproductive age, and Freud having a wet-nurse, may not have experienced the early intimacy that would have tipped off his perceptual system that Mrs. Freud was his mother."

Historical mystique - Ethnocentrism

Bourdieu

In Esquisse pour une autoanalyse, Pierre Bourdieu argues that the success of the concept of Oedipus is inseparable from the prestige associated with ancient Greek culture and the relations of domination that are reinforced in the use of this myth. In other words, if Oedipus was Bantu or Baoulé, his story would probably not be viewed as a human universal. This remark recalls the historically and socially situated character of the founder of psychoanalysis.

Malinowski

Sex and Repression in Savage Society is considered "a famous critique of psychoanalysis, arguing that the 'Oedipus complex' described by Freud is not universal."

Sexism

Feminist views on the Oedipus complex include criticism of the phallocentrism of the theory by philosopher Luce Irigaray among others. Irigaray charges that Freud's work assumes a masculine perspective, epitomized by the centrality of the penis (or lack of a penis for girls) in the Oedipus complex. She thinks that Freud's desire for a neat, symmetrical theory leads him to a contrived understanding of women as inverse men. She charges that he does not explore mother–daughter relationships and that he dogmatically assumes female sexuality will be a perfect mirror of male sexuality.

Evidence

A study conducted at Glasgow University potentially supports at least some aspects of the psychoanalytic conception of the Oedipus complex. The study demonstrated that men and women were twice as likely to choose a partner with the same eye color as the parent of the sex they are attracted to. Another study by anthropologist Allen W. Johnson and psychiatrist Douglas Price-Williams suggests that the classic version of the Oedipus Complex that boys go through is present, with the sexual and aggressive sentiments less repressed in cultures without class separation.

Another study examined adoptive-daughters and choice of husband. The study attempted to distinguish conceptually phenotypic matching from positive sexual imprinting. Phenotypic matching can be understood as an individual's seeking (presumably without conscious awareness) traits in mates that are similar to their own phenotype. Sexual imprinting can be understood as mate preferences that are influenced by experiences and observations with parents/caregivers in early childhood. Adoptive daughters were examined in part to disentangle these two influences. The results of the study support positive sexual imprinting independent of phenotypic matching: "Judges found significant resemblance on facial traits between daughter's husband and her adoptive father. Furthermore, this effect may be modified by the quality of the father–daughter relationship during childhood. Daughters who received more emotional support from their adoptive father were more likely to choose mates similar to the father than those whose father provided a less positive emotional atmosphere." The study's authors also hypothesized that "sexual imprinting on the observed features of the opposite-sex parent during a sensitive period in early childhood might be responsible for shaping people's later mate choice criteria," a hypothesis that would be at least partially in accordance with Freud's Oedipal model.

Encephalitis lethargica

From Wikipedia, the free encyclopedia
 
Encephalitis lethargica
Other namesEconomo's disease; von Economo's encephalitis
An illustration from von Economo's Die Encephalitis lethargica (1918) showing brain tissue of a monkey affected by Encephalitis lethargica, as seen under a microscope
SpecialtyInfectious diseases, neurology 
CausesUnknown
FrequencyUnknown

Encephalitis lethargica is an atypical form of encephalitis. Also known as "sleeping sickness" or "sleepy sickness" (distinct from tsetse fly-transmitted sleeping sickness), it was first described in 1917 by neurologist Constantin von Economo and pathologist Jean-René Cruchet. The disease attacks the brain, leaving some victims in a statue-like condition, speechless and motionless. Between 1915 and 1926, an epidemic of encephalitis lethargica spread around the world. The exact number of people infected is unknown, but it is estimated that more than one million people contracted the disease during the epidemic, which directly caused more than 500,000 deaths. Most of those who survived never returned to their pre-morbid vigour.

Signs and symptoms

Encephalitis lethargica is characterized by high fever, sore throat, headache, lethargy, double vision, delayed physical and mental response, sleep inversion and catatonia. In severe cases, patients may enter a coma-like state (akinetic mutism). Patients may also experience abnormal eye movements ("oculogyric crises"), Parkinsonism, upper body weakness, muscular pains, tremors, neck rigidity, and behavioral changes including psychosis. Klazomania (a vocal tic) is sometimes present.

Cause

Encephalitis lethargica. Its sequelae and treatment – Constantin von Economo, 1931: front page

The causes of encephalitis lethargica are uncertain. Though it used to be believed that it was connected to the Spanish flu epidemic, modern research provides arguments against this claim. Some studies have explored its origins in an autoimmune response, and, separately or in relation to an immune response, links to pathologies of infectious disease—viral and bacterial, such as in the case of influenza, where a link with encephalitis is clear. Postencephalitic Parkinsonism was clearly documented to have followed an outbreak of encephalitis lethargica following the 1918 influenza pandemic; evidence for viral causation of the Parkinson's symptoms is circumstantial (epidemiologic, and finding influenza antigens in encephalitis lethargica patients), while evidence arguing against this cause is of the negative sort (for example, lack of viral RNA in postencephalitic Parkinsonian brain material). In reviewing the relationship between influenza and encephalitis lethargica (EL), McCall and coauthors conclude, as of 2008, that "the case against influenza [is] less decisive than currently perceived ... there is little direct evidence supporting influenza in the etiology of EL", and that "[a]lmost 100 years after the EL epidemic, its etiology remains enigmatic." Hence, while opinions on the relationship of encephalitis lethargica to influenza remain divided, the preponderance of literature appears skeptical.

The German neurologist Felix Stern, who examined hundreds of encephalitis lethargica patients during the 1920s, noted that their encephalitis lethargica typically evolved over time. The early symptoms would be dominated by sleepiness or wakefulness. A second symptom would lead to an oculogyric crisis. The third symptom would be recovery, followed by a Parkinson-like syndrome. If patients of Stern followed this course of disease, he diagnosed them with encephalitis lethargica. Stern suspected encephalitis lethargica to be close to poliomyelitis, without evidence. Nevertheless, he experimented with the convalescent serum of survivors of the first acute syndrome. He vaccinated patients with early-stage symptoms, telling them that it might be successful. Stern is author of the definitive 1920s book, Die Epidemische Encephalitis.

In 2010, in a substantial Oxford University Press compendium reviewing the historic and contemporary views on EL, its editor, Joel Vilensky, of the Indiana University School of Medicine, quotes another researcher, writing in 1930, who states, "we must confess that etiology is still obscure, the causative agent still unknown, the pathological riddle still unsolved", and goes on to offer the following conclusion, as of that publication date:

Does the present volume solve the "riddle" of EL, which ... has been referred to as the greatest medical mystery of the 20th century? Unfortunately, no: but inroads are certainly made here pertaining to diagnosis, pathology, and even treatment"

Subsequent to publication of this compendium, an enterovirus was discovered in encephalitis lethargica cases from the epidemic. In 2012, Oliver Sacks, the author of the book Awakenings, about institutionalized survivors, acknowledged this virus as the probable cause of the disease. Other sources have suggested Streptococcus pneumoniae as a cause.

Diagnosis

There have been several proposed diagnostic criteria for encephalitis lethargica. One, which has been widely accepted, includes an acute or subacute encephalitic illness where all other known causes of encephalitis have been excluded. Another diagnostic criterion, suggested more recently, says that the diagnosis of encephalitis lethargica "may be considered if the patient's condition cannot be attributed to any other known neurological condition and that they show the following signs: influenza-like signs; hypersomnolence (hypersomnia), wakeability, ophthalmoplegia (paralysis of the muscles that control the movement of the eye), and psychiatric changes". Others describe lethargy, "mask-like faces", excess blood in the meninges, and other general neurological symptoms.

Treatment

L-DOPA

Modern treatment approaches to encephalitis lethargica include immunomodulating therapies, and treatments to remediate specific symptoms.

There is little evidence so far of a consistent effective treatment for the initial stages, though some patients given steroids have seen improvement. The disease becomes progressive, with evidence of brain damage similar to that of Parkinson's disease.

Treatment is then symptomatic. L-DOPA (Levodopa) and other anti-Parkinson drugs often produce dramatic responses; however, most people given L-DOPA experience improvements that are short-lived.

History

Occurrences

Retrospective diagnosis tentatively suggests various historical outbreaks of encephalitis lethargica:

  • In 1580, Europe was swept by a serious febrile and lethargic illness that led to Parkinsonism and other neurological sequelae.
  • In 1673–1675, a similar serious epidemic occurred in London, which Thomas Sydenham described as "febris comatosa".
  • In 1695, a 20-year-old woman in Germany experienced oculogyric crises, Parkinsonism, diplopia, strabismus, and other symptoms following an attack of somnolent brain fever, as described by Albrecht of Hildesheim.
  • In 1712–1713, a severe epidemic of Schlafkrankheit ('sleep sickness') occurred in Tübingen, Germany, followed in many cases by persistent slowness of movement and lack of initiative (aboulia).
  • Between 1750 and 1800, France and Germany experienced minor epidemics of "coma somnolentum" with features of Parkinsonism, including hyperkinetic hiccup, myoclonus, chorea, and tics.
  • Between 1848 and 1882, Paris-based neurologist Jean-Martin Charcot documented many isolated cases of juvenile Parkinsonism, associated with diplopia, oculogyria, tachypnoea, retropulsion, and obsessional disorders, which were almost certainly post-encephalitic in origin.
  • In 1890 in Italy, following the influenza epidemic of 1889–1890, a severe epidemic of somnolent illnesses (nicknamed the "Nona") appeared. For the few survivors of the Nona, Parkinsonism and other sequelae developed in almost all cases.
  • Between 1915 and 1926, a world-wide encephalitis lethargica pandemic occurred, impacting nearly 5 million people and killing an estimated 1.6 million people.

Pandemic of 1915–1926

In the winter of 1916–1917, a "new" illness suddenly appeared in Vienna and other cities, and rapidly spread world-wide over the next three years. Earlier reports appeared throughout Europe as early as the winter of 1915–1916, but communication about the disease was slow and chaotic, given the varied manifestation of symptoms and difficulties disseminating information in wartime; it was officially recognized as its own disease in 1917. Some authors define the span of the outbreak as being from 1918 to 1930.

Neurologist Constantin von Economo published a paper in April 1917 describing some of the cases he encountered in the winter months of 1916–1917. These patients, despite varying diagnoses, had a similar pattern of symptoms which led von Economo to suggest a novel disease, which he called Encephalitis Lethargica. In France, physician Jean-René Cruchet was experiencing something similar, and he published his findings within a few days of von Economo. After these two, many more reports began being released about the disease, starting in Europe before moving around the globe.

Until Constantin von Economo identified a unique pattern of damage among the brains of deceased patients and introduced the unifying name encephalitis lethargica, reports of the protean disease came in under a range of names: botulism, toxic ophthalmoplegia, epidemic stupor, epidemic lethargic encephalitis, acute polioencephalitis, Heine-Medin disease, bulbar paralysis, hystero-epilepsy, acute dementia, and sometimes just "an obscure disease with cerebral symptoms". Just 10 days before von Economo's breakthrough in Vienna, Jean-René Cruchet described 40 cases of "subacute encephalomyelitis" in France.

The number of people infected during the ten years of the pandemic is unknown, but it is estimated that more than 1 million people contracted the disease, which directly caused more than 500,000 deaths. Encephalitis lethargica assumed its most virulent form between October 1918 and January 1919.

In the United States the epidemic peaked from 1920 to 1924. It is estimated that as many as one million people were diagnosed with encephalitis lethargica during the epidemic period.

The pandemic disappeared in 1927, as abruptly and mysteriously as it first appeared. The great encephalitis pandemic coincided with the 1918 influenza pandemic, and it is likely that the influenza virus potentiated the effects of the causative agent of the encephalitis or lowered resistance to it in a catastrophic way.

Aftermath

Many surviving patients of the 1915–1926 pandemic seemed to make a complete recovery and return to their normal lives. However, the majority of survivors subsequently developed neurological or psychiatric disorders, often after years or decades of seemingly perfect health. Post-encephalitic syndromes varied widely: sometimes they proceeded rapidly, leading to profound disability or death; sometimes very slowly; sometimes they progressed to a certain point and then stayed at this point for years or decades; and sometimes, following their initial onslaught, they remitted and disappeared. It is also known to cause postencephalitic parkinsonism (PEP). Though often thought of as a disease of the past, it is still seen in occasional cases today.

Notable cases

Notable cases include:

  • Muriel "Kit" Richardson (née Hewitt), first wife of actor Sir Ralph Richardson, died of the condition in October 1942, having first shown symptoms in 1927–28.
  • There is speculation that Adolf Hitler may have had encephalitis lethargica when he was a young adult (in addition to the more substantial case for Parkinsonism in his later years).
  • Mervyn Peake (1911–1968), author of the Gormenghast books, began his decline towards death which was initially attributed to encephalitis lethargica with Parkinson's disease–like symptoms, although others have later suggested his decline in health and eventual death may have been due to Lewy body dementia.
  • Those described in the book Awakenings by the British neurologist Oliver Sacks.
  • Jane Norton Grew Morgan, wife of J. P. Morgan Jr., died of encephalitis lethargica in 1925. At the time, doctors attributed her encephalitis to having contracted influenza during the 1918 pandemic.

Liberal international order

From Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Liberal_international_order

In international relations, the liberal international order (LIO), also known as the rules-based international order (RBIO), or the rules-based order (RBO), describes a set of global, rule-based, structured relationships based on political liberalism, economic liberalism and liberal internationalism since the late 1940s. More specifically, it entails international cooperation through multilateral institutions (like the United Nations, World Trade Organization and International Monetary Fund) and is constituted by human equality (freedom, rule of law and human rights), open markets, security cooperation, promotion of liberal democracy, and monetary cooperation. The order was established in the aftermath of World War II, led in large part by the United States.

The nature of the LIO, as well as its very existence, has been debated by scholars. The LIO has been credited with expanding free trade, increasing capital mobility, spreading democracy, promoting human rights, and collectively defending the West from the Soviet Union. The LIO facilitated unprecedented cooperation among the states of North America, Western Europe and Japan. Over time, the LIO facilitated the spread of economic liberalism to the rest of the world, as well as helped consolidate democracy in formerly fascist or communist countries.

Origins of the LIO have commonly been identified as the 1940s, usually starting in 1945, with some scholars pointing to earlier agreements between the WWII-era Allies such as the Atlantic Charter in 1941. John Mearsheimer has dissented with this view, arguing that the LIO only arose after the end of the Cold War. Core founding members of the LIO include the states of North America, Western Europe and Japan; these states form a security community.[3] The characteristics of the LIO have varied over time. Some scholars refer to a Cold War variation of the LIO largely limited to the West, and a post-Cold War variation having a more widespread scope and giving international institutions more powers.

Aspects of the LIO are challenged internally within liberal states by populism, protectionism and nativism. Scholars have argued that embedded liberalism (or the logics inherent in the Double Movement) are key to maintaining public support for the planks of the LIO; some scholars have raised questions whether aspects of embedded liberalism have been undermined, thus leading to a backlash against the LIO.

Externally, the LIO is challenged by authoritarian states, illiberal states, and states that are discontented with their roles in world politics. China, Russia, Iran and North Korea have been characterized as prominent challengers to the LIO. Some scholars have argued that the LIO contains self-undermining aspects that could trigger backlash or collapse.

Definition

David Lake, Lisa Martin and Thomas Risse define "order" as "patterned or structured relationships among units". Interactions in the LIO are structured by rules, norms and decision-making procedures. They note that the LIO is not synonymous with a "rule-based international order", as non-liberal rule-based orders may exist (such as the Westphalian order).

They define "liberal" as a belief in the universal equality of individuals, as well as individual and collective freedoms. Political liberalism entails the rule of law, and the sovereign equality of states, as well as protections for human rights, political rights and civil liberties. Economic liberalism entails free market-oriented policies. Liberal internationalism entails principled multilateralism and global governance.

Michael Barnett defines an international order as "patterns of relating and acting" derived from and maintained by rules, institutions, law and norms. International orders have both a material and social component. Legitimacy (the generalized perception that actions are desirable, proper or appropriate) is essential to political orders. George Lawson has defined an international order as "regularized practices of exchange among discrete political units that recognize each other to be independent." John Mearsheimer defines an international order as "an organized group of international institutions that help govern the interactions among the member states."

In After Victory (2001), John Ikenberry defines a political order as "the governing arrangements among a group of states, including its fundamental rules, principles and institutions." Political orders are established when the basic organizing arrangements are set up, and they break down when the basic organizing arrangements are overturned, contested or in disarray. He defines a constitutional international order as a political order "organized around agreed-upon legal and political institutions that operate to allocate rights and limit the exercise of power." There are four main core elements of constitutional orders:

  1. Shared agreement about the rules of the game within the order
  2. Rules and institutions that bind and limit the exercise of power
  3. Institutional autonomy from special interests
  4. The entrenchment of these rules and institutions with a broader, immutable political system.

In 2018, Ikenberry defined the liberal international order as:

multilayered, multifaceted, and not simply a political formation imposed by the leading state. International order is not “one thing” that states either join or resist. It is an aggregation of various sorts of ordering rules and institutions. There are the deep rules and norms of sovereignty... There is a sprawling array of international institutions, regimes, treaties, agreements, protocols, and so forth. These governing arrangements cut across diverse realms, including security and arms control, the world economy, the environment and global commons, human rights, and political relations. Some of these domains of governance may have rules and institutions that narrowly reflect the interests of the hegemonic state, but most reflect negotiated outcomes based on a much broader set of interests.

Charles Glaser has disputed the analytical value of the concept of the LIO, arguing that the concept is so broad and vague that "almost any international situation qualifies as an international order, so long as its members accept the sovereignty norm." Some critics of the LIO, such as John Mearsheimer, have argued that liberal democracy promotion and hyper-globalization are elements of the LIO.

Jeff Colgan has characterized the liberal international order as the theme that unites multiple subsystems in the international system. These subsystems can experience drastic change without fundamentally changing the liberal international order.

Debates

The debate about liberal international order has grown especially prominent in International Relations. Daniel Deudney and John Ikenberry list five components of this international order: security co-binding, in which great powers demonstrate restraint; the open nature of US hegemony and the dominance of reciprocal transnational relations; the presence of self-limiting powers like Germany and Japan; the availability of mutual gains due to "the political foundations of economic openness"; and the role of Western "civil identity." According to Charles Glaser, there are five key mechanisms in the LIO: "democracy, hierarchy built on legitimate authority, institutional binding, economic interdependence, and political convergence."

The more supportive views of scholars such as Ikenberry have drawn criticism from scholars who have examined the imperial and colonial legacies of liberal international institutions. The contributions of non-Western actors to the formation of the liberal international order have also recently gained attention from scholars advancing global International Relations theory. In the case of Latin America, for example, "From as far back as the 1860s, Latin American jurists have made prominent contributions to international jurisprudence, the ‘mortar’ that binds international order. [...] However, in other ways, historically the LIO has been—and remains—superficial in its reach in Latin America." According to Abrahamsen, Andersen, and Sending, the contemporary liberal international order includes the legacy of "southern actors" in Africa and Asia advocating the process of decolonization.

International organizations play a central role in the liberal order. The World Trade Organization, for example, creates and implements free trade agreements, while the World Bank provides aid to developing countries. The order is also premised on the notion that liberal trade and free markets will contribute to global prosperity and peace. Critics argue that free trade has sometimes led to social problems such as inequality and environmental degradation.

Post-Cold War, some consider international agreements on issues such as climate change, nuclear nonproliferation, and upholding initiatives in maritime law (UNCLOS) to constitute elements of the LIO. The European Union is often considered a major example of the liberal international order put into effect in terms of international agreements between the constituent countries, while the supranational union has been considered a power in its own right that can uphold the liberal international order. This has led to debates about how the European Union's identity will continue forming in the future, as multilateralism is a core part.

Critics also argue that the liberal order tilts the scales in favour of the United States and its Western allies, as seen in voting shares in the International Monetary Fund and World Bank.

Others argue that weak states played a central role in shaping the liberal international order. Marcos Tourinho argues that weak states used the three strategies of "resistance", "community" and "norms" to push back on U.S. dominance during the construction of the liberal international order, thus ensuring that the order did not just reflect U.S. interests. Martha Finnemore argues that unipolarity does not just entail a material superiority by the unipole, but also a social structure whereby the unipole maintains its status through legitimation, and institutionalization. In trying to obtain legitimacy from the other actors in the international system, the unipole necessarily gives those actors a degree of power. The unipole also obtains legitimacy and wards off challenges to its power through the creation of institutions, but these institutions also entail a diffusion of power away from the unipole. David Lake has argued along similar lines that legitimacy and authority are key components of international order. Abrahamsen suggested that middle powers also benefit from liberal internationalism. By investing in the maintenance of multilateral institutions, moderate powers can collectively advocate for their self-interest, counterbalancing great power politics. Supporting liberal internationalism is thus a form of realpolitik for middle powers.

Realist critics of the LIO include John Mearsheimer, Patrick Porter and Charles Glaser. Mearsheimer has argued that the LIO is bound to fail due to the pushback it faces internally within liberal states and externally by non-liberal states. Porter has argued that the LIO was actually a coercive order and that it was not liberal. Glaser has argued that the balance of power theory, bargaining theory and neo-institutional theories better explain NATO than mechanisms associated with the LIO.

Aaron McKeil finds realist criticism of liberal order insufficient. He argues that the alternative foreign policies offered by realists as "restraint" and "offshore balancing" would be more generative of proxy wars and would fail to offer the level of institutions required for managing great power competition and international challenges.

Relations with individual countries

According to political scientist Charles A. Ziegler, both China and Russia "reject the political dimension of the liberal international order that favors human rights, humanitarian intervention, and democracy promotion." According to Paul Stronski and Nicole Ng of the Carnegie Endowment for International Peace, "the greatest threat to the West of the Sino-Russian partnership emanates from their efforts to adjust the international system to their advantage". Additionally, "Moscow, particularly since 2014, has mounted a revisionist and offensive challenge to the current order, showing a willingness to take substantial risks to weaken Western power within the international system. In contrast to Russia, China recognizes that it has benefited from the liberal international order. The processes of economic liberalism and globalization have facilitated its rapid economic rise over the past thirty years."

China

Some see China as a potential challenger to the liberal order. According to Darrren Lim and John Ikenberry, China seeks an international order that protects its illiberal domestic political and economic model. Scholars cite initiatives such as the Asian Infrastructure Investment Bank and One Belt One Road Initiative as institutions that appear to compete with existing liberal international institutions. Van Niewenhuizen is categorical that Xi Jinping, then General Secretary of the Chinese Communist Party, seeks to supplant the LIO. According to political scientist Thomas Ambrosio, one aim of the Shanghai Cooperation Organisation was to ensure that liberal democracy could not gain ground in these countries, promoting authoritarian norms in Central Asia.

Rühlig asks in his March 2018 paper why China under Xi would seek to change a system by which it earns enormous profit, World Economic Forum fellow Anoushiravan Ehteshami says, "China sees Iran as its Western gateway, where not only is it a big market in itself, but it will also be the gateway to the rest of the Middle East and ultimately to Europe for China." Nisha Mary Mathew remarks that the quest for dominance of the Eurasian land mass in which China finds itself causes Iran to be a favourite. In 2017 alone, the Chinese signed deals for Iranian infrastructure projects worth more than US$15 billion. Joint projects include "high-speed rail lines, upgrades to the nation’s electrical grid, and natural gas pipelines". From 2019 to 2025, the two nations seek to increase bilateral trade to US$600 billion.

Russia

Many scholars agree that the Russian Federation under Vladimir Putin seeks to undermine the liberal international order. Various viewpoints have been developed on the subject. The first is that Russia is a "revanchist power" seeking to completely overturn international diplomacy, the second is that Russia is a "defensive power" that seeks to push incremental change in the existing order, and the third is that Russia is an "aggressive isolationist", with Putin playing a "spoiler role" in international affairs to boost legitimacy domestically.

Political sociologist Larry Diamond argues that Putin's assault on liberal democracy is exemplified by the 2008 military intervention for the enclaves of Abkhazia and South Ossetia against independent Georgia, Russian support for Viktor Yanukovych in Ukraine, and the Russian military intervention in Ukraine by troops without insignia in 2014. Putin has been accused of giving financial support to far-right or national populist parties across Europe. For example, the National Front (now National Rally) obtained a 9 million euro loan from a Russian bank in 2014. Larry Diamond argues this influenced the policy of the National Front such as Marine Le Pen's support for the annexation of Crimea.

The 2022 Russian invasion of Ukraine and a widespread response against the invasion has led to renewed discussion of the liberal international order. Political scientist Lucan Way writes that Putin's invasion has inadvertently strengthened the liberal international order in opposition, with the full-scale Russian invasion being a more conspicuously imperialistic challenge to sovereignty than smaller-scale frozen conflicts and political interferences. Way says that blocs such as the European Union will have more unified action while being currently pillars in the liberal international order. Samir Saran, head of the Delhi-based Observer Research Foundation, says that a renewed emphasis in the liberal international order offers new opportunities for the international community, but hopes that the LIO should maintain interest in global issues after the security crisis in Europe. Edward Luce says the invasion is a serious threat to the international order because, "should Putin succeed, it would legitimise the law of the jungle, where large countries can annex smaller ones with impunity." At the same time, Luce suggests different terminology should be used besides "liberal international order" due to what he says is the selective nature of diplomacy. Kori Schake argues that the Russian invasion has provoked a Western response which strengthens the transatlantic alliance, a main component of the LIO, yet has also involved a global response, with the largest partner being Japan. Schake suggests that Ukraine's own defense is a new strengthening element to the LIO, by showing a stark contrast between liberalism and authoritarianism.

Thermodynamic diagrams

From Wikipedia, the free encyclopedia https://en.wikipedia.org/wiki/Thermodynamic_diagrams Thermodynamic diagrams are diagrams used to repr...