Self-inflicted Blinding Linked to Untreated Psychosis Say Researchers

Posted on February 27, 2012

Researchers reveal in the British Journal of Ophthalmology that the self-inflicted removal of one or both eyes is caused by untreated psychotic illness, such as schizophrenia, and not sexual guilt. This type of self-inflicted mutilating injury has been attributed to sexual guilt in the past. The researchers say the phenomenon - dubbed oedipism, self enucleation or auto-enucleation - is extremely rare. Over 50 cases have been published in medical journals over the past 50 years.

In Sophocles' tragedy, Oedipus the King (Oedipus Rex), there is a prophecy that Oedipus will kill his father and sleep with his mother. Oedipus ends up stabbing himself in both eyes with gold pins. Psychoanalyst Sigmund Freud attributed this type of incestuous sexual attraction to some of his patients in the 19th century. He called it the Oedipus complex.

The researchers say self-blinding has to do with psychotic illness, particularly untreated schizophrenia, and not sexual or religious guilt. There are clearly incidents where fanatics injure or kill themselves over religious beliefs - such as self-immolation and martyrdom - but the researchers didn't associate this type of destructive behavior with the self-blinding cases.

The researchers point to evidence that cases reported to date have come from a wide range of cultures, including China and Japan, and none describe events remotely similar to Oedipus Rex. The researchers also say that in nearly every case the patients held bizarre delusional beliefs about their eyes and had associated hallucinations.

The researchers says, "We concluded that cultural beliefs are not likely to be the cause of self enucleation because they are shared by a large number of people and cannot be a good explanation for the actions of the tiny minority who self enucleate. In contrast, the rare and disturbing psychotic symptoms are a more plausible explanation for self enucleation than Oedipal conflicts or religious guilt. Each case is disturbing and it is perhaps not surprising that doctors have sought to explain the patients' behavior in the secure frameworks of their religious and cultural beliefs. However, a more helpful way of understanding and responding to self enucleation is to recognize that it is a rare complication of severe psychosis that requires urgent medical attention."


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