The Man Who Mistook His Wife for a Hat: "Murder"

The details, manifest on forensic examination, were macabre, and could not be revealed in open court.

Comparison was made with the acts of violence occasionally committed during temporal lobe or psychomotor seizures. There is no memory of such acts, and perhaps no intention of violence—those who commit them are considered neither responsible nor culpable, but are none the less committed for their own and others’ safety.

He seemed to have achieved a sort of austere equilibrium, in which human relations, human passions, previously so tempestuous, were replaced by a strange calm.

He seemed to have achieved a sort of austere equilibrium, in which human relations, human passions, previously so tempestuous, were replaced by a strange calm.

He seemed to have achieved a sort of austere equilibrium, in which human relations, human passions, previously so tempestuous, were replaced by a strange calm.

He had been an avid cyclist, and now he again bought a bike. And it was this which precipitated the second act of his strange history.

He sustained a severe head injury—massive bilateral subdural hematomas, which were at once surgically evacuated and drained—and severe contusion of both frontal lobes.

He sustained a severe head injury—massive bilateral subdural hematomas, which were at once surgically evacuated and drained—and severe contusion of both frontal lobes.

The returning, the re-dawning, of consciousness was not sweet—it was beset by a hideous agitation and turmoil, in which the half-conscious Donald seemed to be violently struggling, and kept crying, 'Oh God!’ and ‘No!’

Uncontrollable reminiscence welled up and overwhelmed him—he kept ‘seeing’ the murder, enacting it, again and again.

That this was a sudden irruption of psychotic phantasy was ruled out by the veridical quality of the reminiscence shown—and even if it were entirely psychotic phantasy, why should it occur now, quite suddenly, unprecedentedly, with his head injury?

There was a psychotic, or near psychotic, charge to the memories—they were, in psychiatric parlance, intensely or over-‘cathected’—so much so as to drive Donald to incessant thoughts of suicide.

There was a psychotic, or near psychotic, charge to the memories—they were, in psychiatric parlance, intensely or over-‘cathected’—so much so as to drive Donald to incessant thoughts of suicide.

But what would be a normal cathexis for such a memory—the sudden emergence, from total amnesia, not of some obscure Oedipal struggle or guilt, but of an actual murder?

Was it possible that with the loss of frontal-lobe integrity an essential prerequisite for repression had been lost—and that what we now saw was a sudden, explosive and specific ‘de-repression’?

None of us had ever heard or read of anything quite like this before, although all of us were very familiar with the general disinhibition seen in frontal-lobe syndromes—the impulsiveness, the facetiousness, the loquacity, the salacity, the exhibition of an uninhibited, nonchalant, vulgar Id.

None of us had ever heard or read of anything quite like this before, although all of us were very familiar with the general disinhibition seen in frontal-lobe syndromes—the impulsiveness, the facetiousness, the loquacity, the salacity, the exhibition of an uninhibited, nonchalant, vulgar Id.

He was not impulsive, unselective, inappropriate, in the least.

Here EEG studies were especially interesting, because it was evident, using special (nasopharyngeal) electrodes, that in addition to the occasional grand mal seizures he had there was an incessant seething, a deep epilepsy, in both temporal lobes, extending down (one might surmise, but it would need implanted electrodes to confirm) into the uncus, the amygdala, the limbic structures—the emotional circuitry which lies deep to the temporal lobes.

Penfield and Perot had reported recurrent ‘reminiscence’, or ‘experiential hallucinations’, in some patients with temporal-lobe seizures. But most of the experiences or reminiscences which Penfield described were of a somewhat passive sort—hearing music, seeing scenes, being present perhaps, but present as a spectator, not as an actor.

Finally, with sensitive and supportive regular psychotherapy, the punitive violence of Donald’s self-accusing superego has been mitigated, and the gentler scales of the ego now hold court.

Finally, with sensitive and supportive regular psychotherapy, the punitive violence of Donald’s self-accusing superego has been mitigated, and the gentler scales of the ego now hold court.

Finally, with sensitive and supportive regular psychotherapy, the punitive violence of Donald’s self-accusing superego has been mitigated, and the gentler scales of the ego now hold court.

Donald has not forgotten, or re-repressed, anything of the murder—if, indeed, repression was operative in the first place—but he is no longer obsessed by it: a physiological and moral balance has been struck.

Why the amnesia—and the explosive return? Why the total blackout and then the lurid flashbacks?