Psychiatric report on a request for voluntary castration

[SplitDik (imported)]

Very, very interesting ... shows a psychiatrist's response to a request for voluntary castration.

http://ajp.psychiatryonline.org/cgi/con ... /155/3/415

It's a long article, maybe someone can capture it an put it in the Story Archive or something?

History of the Presenting Problem

An Anglo man who introduced himself as "Brother David," a "monk" from "Ascension Monastery," was referred by a urologist in private practice for a psychiatric evaluation at the University of New Mexico Health Sciences Center during the summer of 1995. The consultation was prompted by concern about the patient's request for an elective bilateral orchiectomy. The patient could not explain the urgency behind the request, and he denied a recent or specific precipitant for it. He was willing to comply with the psychiatric evaluation simply because he thought that the urologist would "help" him if the psychiatrist said it was "OK."

Over the course of five evaluative sessions with one of us (M.H.), the patient stated that he wished to undergo an orchiectomy because he felt that his sexual impulses interfered with his spirituality. He described his sexuality as a stumbling block and a barrier between himself and "the Creator." He had worked hard for many years to minimize and master his sexual feelings and felt that he had achieved good success. Nonetheless, he felt that castration was the final and best option to ablate his sexuality. His body, he said, was merely a tool of the mind and spirit. He described his testicles as obsolete, useless, and harmful to his purpose in life. He likened his genitalia to "a pest.a fly you swat away that keeps coming back." He also described guilt, shame, and conflict surrounding his sexual impulses. However, this was not the case for his nocturnal erections ("when the vehicle wants to stimulate itself"), which he saw as normal physiology. He reported that a past trial of finasteride had not been helpful. He stated that he had been considering the orchiectomy procedure for 10 years and thinking seriously about it for the preceding 2 years.

In describing the beliefs behind his castration request, Brother David talked about other "monks" he knew who felt that castration had been helpful to them in diminishing or eliminating their sexual impulses. In this context, he lamented his male hormones as "a lot of chemistry that I don't need.stimulating areas I have been trying to ignore, or move on from." He felt that his refractory sexual nature was a feature of "lower existence." He repeatedly suggested that his hormones might, in fact, be partially responsible for his rebelliousness with respect to following rules in the monastery. In explaining his wishes, Brother David referred to two scripture passages: "If your right hand offends you, cut it off" and "there be eunuchs, which have made themselves eunuchs for the Kingdom of Heaven's sake. He that is able to receive it, let him receive it." When asked whether it might, in some way, be a spiritual failure to need an orchiectomy to deal with his sexuality, he replied, "[God] cares about overcoming, not how you overcomeIs it a failure for a cripple to be given crutches?" He expressed chagrin over the difficulties he had experienced in complying with the restrictions of his religious life, but he felt that overall he had gained much more than he had lost by joining the monastery.

[continues much further ...]

[JesusA (imported)]

The entire text of this article, as well as that of a response to it, is now posted on the Nonfiction Board at Psychiatric Evaluation of a "Monk" (http://www.eunuch.org/vbulletin/showthread.php?t=6123)

I find the article very disturbing for what it says about the current state of psychiatry. It will take me a while to frame an appropriate response, which will be posted back here on this thread.

All comments about the article should be posted HERE, rather than on the Nonfiction Board.

[SplitDik (imported)]

I thought the psychiatrists were fair about the whole thing, but the urologists seem to only be concerned with covering their own asses.

It really is a tough thing for a psychiatrist -- someone with an "out there" religious belief asks for a serious voluntary amputation.

[A-1 (imported)]

HAH!!!

Most of the Psychaitrists that I have known personally just wanted to FUCK their crazy, attractive Female Patients, or perhaps thier mothers if they are young or good looking enough!

That is why they cannot be objective about castration.

The FUCKERS! them, CASTRATE them!





A-1

[TheOtherSide (imported)]

The 'Letter to the Editor' response though, clearly shows a large number of the worst aspects of psychiatry. It's author not only attempts to rescript the entire approach (Monday morning quarterback), using the outcome to essentially state that certain items should have been obvious in retrospect. Worse, though, he clearly indicates his own opinion of castration is that the desire "[is] prima facie insane!" He also makes the comparison between a desire to be castrated, and a patient who has "requested amputation of his right arm because he suffered from repeated impulses to punch people."

It is psychiatrists like this (and it seems to be the majority view), who give the profession a bad name.

Personally, I am amazed the original doctor posessed such an open mind to the entire idea, and hope that the outcome will not deter him from being equally open should another enter his office with the same request.

[SplitDik (imported)]

I've been lucky with psychiatrists. All of them have listened thoughfully, given properly measured advice, and offered chemical castration regimens as the proper way to test whether castration is the answer.

On the other hand, even with my understanding of the castration desire I have to admit that it is an "amputation". Can you really fault other people to make such analogies?

The only reason I think castration makes more sense than cutting off a hand is that the testicles actually produce the hormones which we know have a dramatic physiological and psychological effect. Anyone who doubts the substantial effect of testosterone should simply look at a body building magazine!