Year: 2019

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I will briefly go over the forms of dissociation to help understand its causes and effects.  I will mainly focus on dissociative anesthesa, which is used to help control pain for medical reasons such as emergency injuries.  This has also been abused to produce a trance like state or an out of body experience (hallucination) that’s been noted to be like a pleasant dream like state.  I will go over Timothy Leary’s thoughts about hallucinogen drugs such as dissociative drugs.  Also documented experiences from users of the dissociative drugs.  I will tell about medical risks that go along with this and how it can be diagnosed and treated.

            There has been a huge amount of information on posttraumatic and dissociative disorders resulting from childhood abuse.  There is no easy way to treat survivors and their families.  Understanding dissociation and its relationship to trauma is basic to understanding the posttraumatic and dissociative disorders.  Dissociation is the disconnection from full awareness of self, time, and/or external circumstances.  It is a complex neuropsychological process.  Dissociation exists along a continuum from normal everyday experiences of disorders that interfere with everyday functioning.  Common examples of normal dissociation are highway hypnosis (a trance-like feeling that develops as the miles go by), “getting lost” in a book or movie so that one loses a sense of passing time and surroundings, and daydreaming.  Researchers and clinicians believe that dissociation is a common, naturally occurring defense against childhood trauma.  Children tend to dissociate more readily than adults faced with overwhelming abuse, it is not surprising that children would psychologically flee (dissociate) from full awareness of their experience. Dissociation may become a defensive pattern that persists into adulthood and can result in a full-fledged dissociative disorder.

There has been made a dissociative spectrum that shows all the possible forms of dissociation.  The dissociative spectrum extends from normal dissociation to poly-fragmented DID.  All of the disorders are trauma-based, and symptoms result from traumatic memories.  Braun Bask made this spectrum in 1988.

The Dissociative Spectrum

Normal                Dissociative        PTSD          DDNOS          DID          Poly-fragmented

Dissociation      Amnesia/Fugue                                                                                    DID

I will briefly go over each disorder.  If the disturbance mainly occurs in memory, it’s a Dissociative Amnesia or Fugue disorder.  Posttraumatic Stress Disorder (PTSD) is recalling or a re-experiencing of the trauma (flashbacks) which alternates with numbing (detachment or dissociation), and avoidance.  Atypical dissociative disorders are classified as Dissociative Disorders Not Otherwise Specified (DDNOS).  If the disturbance occurs primarily in identity Disorder (DID), formerly called Multiple Personality Disorder. 

Although DID is a common disorder (perhaps as common as one in 100), the combination of PTSD-DDNOS is the most frequent diagnosis in survivors of childhood abuse. These survivors experience the flashbacks and intrusion of trauma memories, sometimes not until years after the childhood abuse, with dissociative experiences of distancing, “trancing out”, feeling unreal, the ability to ignore pain, and feeling as if they were looking at the world through a fog.

Symptom profile of adults who were abuse as children includes posttraumatic and dissociative disorders combined with depression, anxiety syndromes, and addictions. Here are some of the several symptoms of dissociation disorders.  (1) Recurrent depression; (2) anxiety, panic, and phobias; (3) anger and rage; (4) low self-esteem, and feeling damaged and/or worthless; (5) shame; (6) somatic pain syndromes (7) self-destructive thoughts and/or behavior; (8) substance abuse and (9) alternative states of consciousness or personalities.

The diagnosis of dissociative disorders starts with an awareness of the prevalence of childhood abuse and its relation to these clinical disorders with their complex symptomatology.  In the past, individuals with dissociative disorders were often in the mental health system for years before receiving an accurate diagnosis and appropriate treatment. As clinicians become more skilled in the identification and treatment dissociative disorders, there should no longer be such delay.

The heart of the treatment of dissociative disorders is long-term psychodynamic/cognitive psychotherapy facilitated by hypnotherapy. It is not uncommon for survivors to need three to five years of intensive therapy work. Setting the frame for the trauma work is the most important part of therapy. One cannot do trauma work without some destabilization, so the therapy starts with assessment and stabilization before any abreactive work (revisiting the trauma).  The journey is long and painful, but the reward is great for a survivor’s life.

Know that we understand the basis of dissociation and dissociation disorders and what happens such as “trancing out”, feeling unreal, and the ability to ignore pain (in the complex forms of the dissociative spectrum) we can see the related affect of the abuse of dissociative drugs such as dissociative anesthesia.  First I will go over what dissociative anesthesia is and what it is used for.  Dissociative anesthesia is a unique method of pain control.  It reduces anxiety and produces a trancelike state.  The person is not asleep, but rather feels separated from his or her body.  Dissociative anesthesia is useful in emergency situations, such as an injury. It can also be used for short procedures that are painful, such as changing bandages. This method is safe and lasts only a short time. Because a person does not usually recall the procedure, this method is useful in children. 

The medications used for dissociative anesthesia are given through a shot into a muscle or through an intravenous line, or IV. An IV is a thin tube that is usually placed into one of the veins of the forearm or hand. The medication quickly takes effect. The primary medication used is called ketamine, (which I will go into further detail later).  A sedative is often given before ketamine to reduce anxiety.

A single dose of ketamine produces a trancelike state for about 10 to 30 minutes and pain control for about 30 to 45 minutes. A pinprick is often used to make sure the person doesn’t feel pain. The procedure is then performed. Additional doses of medication can be given if the procedure takes longer than expected.  The individual’s eyes stay open during the procedure, but he or she is in a daze and feels no pain.

A person who has had dissociative anesthesia usually does not remember the procedure, especially if a sedative has been given along with the pain medication.  Most people feel back to normal within a few hours. As the medication wears off, an individual may have intense dreams and even hallucinations.  If the procedure corrects the problem and a hospital stay is not needed, the person can go home. Someone else must drive the person home, because the medications can impair coordination and reflexes for several hours.  Once at home, a person may have effects as a result of the procedure or injury, but usually not as a result of the medication used for dissociative anesthesia.

When the medication is wearing off, a person may have frightening dreams or hallucinations. Dissociative anesthesia is generally avoided in a person with a psychosis because it can cause severe anxiety. Other problems are rare, although allergic reactions to the anesthesia are possible.  The American Society of Anesthesiologists recently issued a warning about the potential side effects and interactions of herbal remedies with medications used before, during, and after surgery. The group recommends discontinuing all herbal remedies and supplements at least two weeks before planned surgery.

Ketamine is psychedelic anesthetic classified medically as a dissociative anesthetic, discovered by Dr. Cal Stevens of Wayne State University in 1961.  Heavily used on the battlefields of Vietnam, it is used today for short-term surgical procedures in both animals and humans.  For human consumption, it is marketed as Ketalar by Parke-Davis.  It is sold legitimately only to hospitals and physicians.  Since it does not depress critical body vitals as much as other anesthetics, it is often used in procedures with burn victims, for example. It produces a dissociative state in the central nervous system in which amnesia and profound analgesia (loss of pain) are induced, though the patient does not appear to be asleep.

Abuse of ketamine goes hand in hand with drugs like gamma hydroxy butyrate (GHB) and MDMA (Ecstasy). Where you find one, you will likely find the others. All three are very popular with the RAVE party crowd.  Ketamine may produce pleasant dream-like states, vivid imagery, hallucinations and possibly extreme delirium. This usually lasts only a few hours. Ketamine is essentially a less-potent version of PCP. While ketamine and GHB and MDMA provide out of body experiences, it is still a bit below the level of PCP trips, but that varies with the amount taken and other drugs combined with it. Flashbacks from ketamine are common.  Ketamine is also used in sexual assault on occasion since it puts the victim in a frozen state for at least a brief period of time. The ability to induce a lack of awareness to the environment is the effect abusers crave.  It was big in the 70’s with New Age types like Dr. John Lilly and Timothy Leary, but its been coming back by having a steady increase since the 1990’s.

             Ketamine comes in injectable form, liquid, for legitimate use. It is most commonly dried.  The crusty residue is ground to a fine powder is inhaled. The liquid form may be applied to smokable material or consumed in drinks. Powdered K has been encountered in one-inch ziplock baggies, paper folds or capsules.  In order for a vial of ketamine to be in an abuser’s hand, someone has already smuggled it in from Mexico or robbed or burglarized a vet clinic or pharmacy, or in some other manner diverted the product for illicit use.

Ketamine is most commonly called Ket, K or Special K; it may also be referred to as Green. Other names include 1980 Acid, Super C, Vitamin K, Super Acid, Special LA Coke, Baby Food and God (because users often are convinced they have met their maker), Jet, Honey Oil, Blast, and Gas. A dose is called a “bump.” The K-hole is where you go when on it and K-head is a name of a user.

While ketamine is approved for commercial use as a veterinary product in cats and monkeys for short-duration surgery or immobilization, it is also used in human medicine.   Ketamine was also used for battlefield injuries for rapid induction.  Ketamine has been used for repeated procedures such as radiation therapy.  Tolerance and psychological dependence can develop with daily exposure. Chronic users may have short-term memory loss; impaired vision or attentions span limitations. A number of Ketamine-related deaths have been recorded across the nation.  For RAVE users excitement and visual disturbances can recur days or weeks after exposure to ketamine. The problem with “flashbacks” may be greater with ketamine than with other hallucinogens.  It also produces ataxia, slurring of speech, dizziness, confusion, blurred vision, anxiety and insomnia. It can also cause cessation of breathing, cardiac arrest, brain damage and death.

Timothy Leary, a Harvard Professor during the mid1960’s had researched hallucinogen drugs.  Although he mainly studied L.S.D. he recognized that dissociative anesthesia affects appear to selectively interrupt association pathways to the brain before producing somesthetic sensor blockage.  He identified a genetic type whose future circuits have begun to be activated and coined them FUTANTS.  Futants are naturally selected to facilitate survival by being better adapted to explore the future and take risks through their genetic characteristics.  Timothy Leary did not discourage this kind of drug use.  He felt drugs should be studied because we can learn from them.

I found a website about a man named Erowid who recorded what he saw while on drugs (a trip) and described his views about drugs such as dissociative anesthetics.  The opening paragraph is as follows.  “I have read many articles and other literature on and by Timothy Leary, Albert Hoffman, William Burrougs, and Hunter S. Thompson. I have also researched the realms of mythology and the use of dissociatives in discovering ones self and mind.  I have never really understood human behaviors; in fact it strikes me as rather odd and ritualistic. From the beginning I have doubted that we have found the full extent of our minds.  Since then I have desperately trying to find some ‘gate way’ so to speak which would allow me to discover these regions of the mind. Thus I found dissociative anesthetics.”  He also documented his trip while on a combination of drugs including a hallucinogen drug Ketamine.  I won’t write down his entire journal entry, but I will still sum up what he believed to see and what he comprehends them to mean.  He started by popping two dots, smoking a joint and then he took a shot of Ket. (He doesn’t describe what dots are) He almost immediately felt familiar sensations of dissociative anesthesia.  His perception of time was altered and felt like he was swimming in space.  Then snorted a cap of meth and went outside to lie down.  He felt acid creeping up his spine.  A feeling of warmth and coziness along with an array of colors consumed him.  Then he felt as if he was on the worst place of the earth.  He was looking for answers and was looking all around him.  When he looked down he saw his feet but no floor.  Then he was talking to one of his favorite author and he said to him once he found what he was looking for the answers would become clear.  Then he was in a bar looking at different colored people and found himself talking to a women who held what he as looking for the answers he seeked it was in a box. He can’t remember their conversation or what was in the box but believed he found his answers and his mind wont let him remember it.  This story tells us how devastating hallucinogen drugs such as dissociative anesthesia can be on our brains. 

Related fields in the studying human behavior and how the brain works would be psychology.  Also a drug attic consoler would be related to my subject.  Having knowledge of drugs physical and mental affects on the body would be able to assess a person’s addiction and be able to treat it.  Psychiatric institute worker to treat people of dissociative disorders.  Therapists related jobs. There are many jobs that could relate to my topic.

Abusing ketamine easily can go along with using other drugs since ketamine can be found at the RAVE scene.  There are usually many drugs that go around at RAVES such as ecstasy.  Tobacco use could easily be used in this environment where hard drugs are being used.  Smoking before or after ketamine is probably not uncommon.                                                                              

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Joel Clark
Professor Hilgers
English 102
16 December 2007
Edgar Allen Poe:

“’The Raven’ has had a great run…but I wrote it for the express purpose of running-just as I did the ‘Gold Bug’…the bird beat the bug, though, all hollow”, Poe wrote in a letter to his close friend, F. W. Thomas, on May 4, 1845. Edgar Allen Poe writing career was of that purpose, “running.” Poe was born in Boston the 19th of January 1809. The Poe pedigree can be traced to north Ireland, were General David Poe, Edgar’s grandfather took leave to settle down in Augusta, Georgia. Poe’s father, David Poe was a traveling actor who married Elizabeth Arnold, who happens to be a talented actor, singer, and dancer. David abandoned Elizabeth, leaving her to fend for the children. David leaves the family never to be seen again. Poe wasn’t yet three years old when his mother suffered from exposure endured during travel. She died in a theatrical rooming house in Richmond, Virginia. The children were then separated into different families; John Allan and his wife had taken in Edgar. They had the wealth to fund Poe’s education.
Poe started his study at the Manor House School at Stoke Newington, then classical education in Scotland, and final destination the University of Virginia. 1827, his academic career ended; he fell into debt gambling and dropped out. He had
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managed to publish a forty-page booklet entitled “Tamerlane and Other Poems by Bostonian” in Boston by the age of eighteen. The same year he enlists to the army as a private under the name Edgar A. Perry. The army records a description of Poe’s appearance. “He gave his occupation of as that of a clerk, his age as twenty-two; the record as existing in army documents describes his height as five feet, eight inches, his eyes grey, his hair brown and his complexion fair.” It has been claimed by phrenologists that a line dividing his face perpendicularly separated very dissimilar halves, as if each expressed a different side of his nature. His army life would later shape charters within his writing. Honorably discharged, his service in the army ended in 1828. Poe later entered into the academy at West Point. This was a means of living for Poe, one that was a poet prison for him. Poe had intentions to leave and then one day the axe just fell. 1831, Poe was court martialed and expelled from the academy only serving a little over one year.
Poe fell on some hard times after he left West Point. Though his reputation for his poems grew, he was financially unstable. He could no longer depend on his foster father’s help. When John Allen died with his large fortune not a cent was to go to Poe. Poe had a weakness for alcohol, at times excessively binge drinking. He was able to have Carey & Lea agree publish a book for him, and also was able to submit tales to various magazines. Poe married his cousin Virginia Clemm who was only fourteen at the time. Poe then did literary work for “The Southern Literary Messenger” at Richmond. He had megar salaries, but managed to support his wife and her mother Poe called Muddy. Poe

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would fall into episodes of great depression were at times would write to his friend Kennedy in search of hope. “I am wretched and know not why. Console me-for you can. But let it be quickly-or it will be late. Write me immediately. Convince me that it is worth one’s while that it is necessary to live, and you will prove yourself indeed my friend. Persuade me to do what is right.” Poe left “The Messenger” in 1836 to find work else were. He went to New York, there he lived in a small home and wrote “The Narrative of Arthur Gordon Pym”. Poe moved again in search of work to Philadelphia, as a editor for an “Gentleman’s Magazine.” He stayed in Philadelphia for six years. There he shared a small brick tenement with Virginia in which she grew out a garden for the home. Poe built up an impressive writing career with several published works and recognition from critics. Poe continued to edit for the “Granham’s magazine” in 1841 when George R. Granham had bought out Burton, Poe’s former boss for the rights to the magazine. He resigned from the magazine in April 1843. Poe had ambitions to start a magazine of is own some day. He aimed on calling the magazine “The Stylus.” In April 1844 his wife had ruptured a blood vessel and became very ill, he took his wife and her mother to New York for the second time. Here he almost persuaded Dr. T. H. Chivers, a fellow poet to help fund the magazine project. Unfortunately, Poe was never able to get the magazine up and running and fell into old temptations.
Poe’s was engaged in criticisms amongst other poets. He took himself as a serious critic, often giving severe remarks in his criticism. He published “The Raven” in 1845 and it was an immediate success. Even so, he had made enemies with his strong opinions and resentful nature towards society. “So verbal and so purely selfish that he
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can no longer have any sympathy with him”, proclaimed Charles F. Briggs in reaction to Poe’s published criticisms. Critics took shots at him by pointing out his faults with drinking. In 1846, Poe was receiving vicious insults from critics when “The Cask of Amontillado” was published, and had no doubt been a way of venting frustration. Poe made vows to give up alcohol for good, as a promise to his close friends. He remained focused on his writing including revising earlier poems for final adjustments to the end of his career.
January 13th, 1847 Poe’s beloved wife Virginia dies. Poe begins to slow down. He has great sorrow in his heart for the loss of his wife. He begins to move around between different places and reunites some old friendships. He finds romantic interest in some new women. Nothing that amounts to the role the Virginia had filled in his life. Poe makes his way to Baltimore; there he is found by Joseph walker to be described strangely dressed and semiconscious. The cause for Poe’s ailment is argued from intoxication to a form of rabies. Poe was then driven to the hospital of Washington medical college; there he died on October 7th, 1849. His dieing words were “Lord help my poor soul.”
The means for Poe to write was something that he was compelled to do. He found times of depression in his life that all have felt at one point or another, but not to the length Poe knew. His poems often reflected his sense of discontentment towards society. His writings were an means of expression that he kept up since his first published works at the age of eight-teen to his death at forty. His works became

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increasingly refined as he held his writing to a very high standard. “The Raven” was Poe’s great success translated into every major language and was renown as a great piece
of literature. The poem appeals to a large group of readers who share empathy for Poe’s artistic expression. The subject of mortality is often addressed in Poe’s writings. “The Raven” tells of a man stricken by grief over a lost love named Lenore. Poe’s writing has an intensity that seems come from the soul. The declining health of Virginia must have affected Poe as he wrote “The Raven.” The poems sense of sorrow must have been came from fears that he would lose his beloved wife Victoria. This bad dream came true two years later. The demon bird that speaks nevermore was to be a raven, as the theme of mortality and the existence of a soul.
“…And my soul from out that shadow that lies floating on the floor
Shall be lifted evermore.”
Poe’ friend Henry B Hirst happened to own a tamed raven which Poe would studied a good extent. He told Hirts “That bird [a raven], that imp bird pursues me, mentally, perpetually; I cannot rid myself of its presence;…I hear its croak as I used to hear it at Stoke Newington, the flap of its wings in my ear.” Driven into the depths of despair the narrator interrogates the raven in alternative manor then peace and tranquility. His questions resonating from his inner soul. A sense of torment can be interpreted in the poem as tapping at the chamber door. There are many ways of criticisms that can be formulated, but on what grounds? The piece of literature should be held up to the principles of art. The expressive as well as compositional forms of expression. Poe has

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been called “the greatest artist of death” as his story telling for horror was renown. His writing can be criticized on merit of soul, art, composition, and his fancy of imagination
that was uniquely Poe’s style. The frightening story of a raven’s presence on the grief stricken narrator.
“…Tell this soul with sorrow laden if, within the distant Aidenn,
It shall clasp a sainted maiden whom the angels name Lenore”. “The Raven” embodies Poe life as the express purpose of running. Locking a part of his self in his writing Poe managed to be one of the most influential poets of the 1900’s and has continued to be read as a sincere writer with a heavy heart.

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Work Cited
Dole, Nathan Hakell. The Complete Works of Edgar Allan Poe. 1 vols. (biography) New York: Werner Company, 1908.
Dole, Nathan Hakell. The Complete Works of Edgar Allan Poe. 7 vols. (criticisms) New York: Werner Company, 1908.
Dole, Nathan Hakell. The Complete Works of Edgar Allan Poe. 8 vols. (criticisms) New York: Werner Company, 1908.
Dole, Nathan Hakell. The Complete Works of Edgar Allan Poe. 9 vols. (criticisms) New York: Werner Company, 1908.
Mabbott, Thomas Ollive, ed. Collected Works of Edgar Allan Poe. 1 vols. Cambridge: Harvard University Printing Office, 1969.
Benitez, R. Michael, Dr. “Poe’s Death Is Rewritten as Case of Rabies, Not Telltale Alchohol.” The New York Times 15 Sept. 1996.
< http://www.online-literature.com/poe/>. 2007.