A Word on ‘Kill Holes’

The Mimbres were pre-Columbian native Americans who flourished in the southern part of what is today Arizona and New Mexico from the 11th to 13th centuries CE. They were part of the larger Mogollon culture, and are recognized primarily for the wonderful examples of pottery which they left as their legacy.

Interestingly, Mimbres archaeological sites, though known to exist since the 1880s, were unnamed until the turn of the 20th century, and even then were largely ignored by academics who had greater interest in reaching more impressive Pueblo sites not far distant. [The name ‘Mimbres,’ by the way, is from the Spanish for ‘willow tree,’ many of which apparently grew alongside nearby creeks – we do not know what these people actually called themselves].

Mimbres pottery employs designs of both a geometric and figural nature. The figures, animals and humans, range from the realistic to the whimsical. And from examining extant grave sites, it is postulated that the pottery was created by female artisans, and was initially fabricated with utilitarian, as opposed to ceremonial, uses in mind.

In 1914, Professor Walter Fewkes of the Smithsonian Institute visited New Mexico and was shown a number of pots and fragments by locals which he immediately recognized as artistically different from other recognized native works from the Southwest. When taken to the sources, all that Fewkes found at first were potsherds and skeletal remains strewn across the ground from clumsy amateur diggings.

Sadly, Professor Fewkes’ subsequent scholarly articles on his discoveries had an unintended consequence. His documentation of the Mimbres pottery tradition spurred further interest from grave robbers. That interest, coupled with the Great Depression and lack of government resources to protect and professionally examine the sites, lead to wholesale commercial desecration of Mimbres burial plots, including the bulldozing of sites with heavy machinery to access pots as quickly as possible.

The plundering of some Mimbres sites falls into a decidedly legal grey zone. Looting on national lands is now uniformly prohibited under the Federal Archaeological Resources Protection Act and the Native American Graves Protection and Repatriation Act, and states have enacted their own proscriptions. However, digging on private lands is far less regulated, if for no other reasons than that it is harder to monitor those tracts, and more difficult to prove criminal intent if a private land owner gave ‘permission.’

The Quarrells’ case is one on point. In February 2000, officers from the USDA Forest Service detected a disturbance at a Mimbres site inside New Mexico’s Gila National Forest. There they found brothers James and Mike Quarrells, and nephew Aaron Sera, digging with picks and shovels. Sera pled guilty to misdemeanor trespassing; the Quarrells faced felony charges stemming from destruction of the site under ARPA and NAGPRA. The Quarrells claimed that the damage at the site was caused by other looters and that they had actually just arrived before being apprehended by the Feds. The court did not buy this argument, and the Quarrells were found guilty in 2002 and given 366 days of incarceration and a fine of close to $20,000.

The Quarrells appealed, saying that they were not permitted at trial in U.S. District Court to present a defense based on a then-stated belief that they were excavating on private land. While the government agreed that such a defense would speak to the presence or absence of criminal intent vis a vis Federal statutes, the evidence suggested that this was not applicable in the case at hand, in no small part because the Quarrells already had been convicted of looting a Mimbres site nearby in the Gila 27 years earlier!

There is one final point of interest, pertinent to the Alienist’s decidedly macabre bent, that should be mentioned:

Mimbres inhumations were performed such that the deceased was placed in the grave in an upright crouching position with a pottery bowl placed over the head.

If you Google ‘kill hole,’ you will find numerous hits for the 2012 film directed by Mischa Webley about a troubled Iraq War veteran who pursues a sociopath in the Pacific Northwest. You have to go a bit further down the results to learn that the Mimbres intentionally broke a hole – a ‘kill hole’ as we call it today – in their funereal pottery in order, it is suspected, for the spirit of the dead to escape to the next world.

Mimbres Pot with 'Repaired' Kill Hole

Mimbres Pot with ‘Repaired’ Kill Hole (courtesy of Smithsonian Institution)

Typical Kill Hole

Typical Kill Hole (courtesy GreatGatsbys.com)

Gila Salado Polychrome (not Mimbres) Pot with Kill Hole

Gila Salado Polychrome Pot (not Mimbres) with Kill Hole (courtesy of The Alienist)

Later Mimbres burials appear to have ceased exclusively placing pots over the heads of the deceased in favor of merely placing pots with kill holes in the graves alongside the corpses. Some neighboring native societies later adopted and adapted this ritual as well. Accordingly, curators find Mimbres and other native pots that are too small to fit over a head but that still contain period kill holes.

Not realizing the symbolic meaning of the kill holes, many collectors in years past had the holes in their pots’ bases ‘repaired.’ These misguided restorations can still be seen in museums and private collections to this day.

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[Copyright 2013 @ The Alienist’s Compendium]

Clear as Mud

I was recently asked, as a favor to a colleague, to present at a prison mental health conference taking place out-of-state. It was aimed primarily at masters level psychologists and licensed clinical social workers, with a few registered nurses in attendance for good measure. As far as I could tell, I was the only psychiatrist at the gathering.

One of the other speakers was a former psychiatric patient who had come to share with the audience some of her observations about being incarcerated and hospitalized in the past, and what it is like to struggle with a mental illness in an environment not always designed to be therapeutic.

I was rather amazed by this woman’s presentation. She comported herself with ease in front of the large audience, explaining the advocacy work she performs for others suffering from mental illnesses, and listing the boards and advisory committees on which she serves. She gave an organized and interesting talk, which was then followed by numerous questions that she fielded without difficulty.

So why was I surprised? Because she told the audience that she was diagnosed with chronic paranoid schizophrenia (CPS) and continued to hear voices despite reported full compliance with her Rx and follow-up appointments. And she manifested none of the negative symptoms of CPS (e.g., social withdrawal) which are usually the hardest facets of the condition to control.

Yes, I’ve seen A Beautiful Mind (2001), and no, the vast majority of those afflicted with psychotic illnesses do not teach at Ivy League institutions and win Nobel Prizes. Hollywood does much better at portraying stereotyped caricatures or spinning feel-good yarns, and rarely do film studios handle the subtleties and realities of mental illness with much aplomb.

The non-Tinseltown truth about that movie’s subject, Professor John Nash, said to also suffer from CPS, illustrates the more typical progression of his mental disease. In real life, Professor Nash’s hallucinations did not apparently start until after he had finished graduate school, and then they were, and remain, entirely auditory in nature; in the movie, he appears to suffer both auditory and visual hallucinations while still in school, suggesting a far less auspicious prognosis than was actually the case.

Prof John Nash (courtesy of NewScientist.com)

Prof John Nash (courtesy of NewScientist.com)

Secondly, Professor Nash apparently did not take any psychotropic Rx from 1970 through the mid 1990s when he won the Nobel. Intrinsic genius notwithstanding, his mental stability at times was so tenuous during that period that he wasn’t asked to present a Nobel lecture, as is always the case with laureates, because of fear that the stress of preparation and delivery would tip him over the edge.

“But,” the reader may say, “he wasn’t taking Rx…. If he had taken Rx, he would have done much better.” That, too, is a difficult supposition to address. While most of those afflicted with schizophrenic-spectrum conditions gain greater stability with Rx than without, note that Rx does not ‘cure’ such diseases, rather only controlling them. And even with control, there are oftentimes those symptoms that persistently and intermittently re-emerge, as well as those which partially remit but remain as constant background noise. Prognosis is always guarded, and there are at present no magic bullets.

In other words, Professor Nash didn’t conquer CPS, especially in the absence of Rx. He was tormented by the disease throughout the period in question, and it was only his genius that surmounted the psychosis and allowed him to accomplish as he did. His appears to be an exceedingly rare case indeed.

I’ve never met Professor Nash, but I suspect that were I to be afforded the opportunity, on Rx or off, he might well exhibit some eccentricities and negative symptoms typical of the ailment with which he is said to grapple. It’s just a guess on my part, but it’s one based on decades of dealing with those with psychotic thought disorders.

In the hour during which she was on stage, however, the speaker at my mental health conference exhibited no stereotypical behaviors or negative symptoms of the purported disease. If anything, she was fully socially engaged with the audience, a facet of conduct that is almost always one of the first things ‘to go’ when a thought disorder blossoms.

So why the difference? Perhaps the speaker’s Rx and treatment plan work far better than for most others. I suspect, though, that the answer lies more with the diagnoses my discipline has employed than with the actual disease states at hand.

In my recent book, A Lawyers’ Guide to Understanding Psychiatry (ABA Publishing, 2012), I discuss at length how my profession came to the Diagnostic and Statistical Manual (the so-called ‘Bible of Psychiatry’). In short, it was by lurching from one imperfect diagnostic schema to the next. There was nothing about the DSM when it was first published in the early 1950s that suggested that this book would ‘take off.’ I think it was just in the right place at the right time, and clinicians had by then grown tired of the lack of taxonomic consistency. But the tome’s subsequent commercial success aside, I’m not certain that there was much particularly scientifically advanced regarding the DSM vis a vis potential alternative diagnostic classifications. In other words, the DSM was imperfect, but it was the best we had at that point, and probably that is still the case.

The history of psychiatry is replete with examples of loose diagnostic criteria and subjectivity in evaluation.

Looking back through state hospital records from the turn of the last century is both comical and heart-breaking: “softening of the brain,” “exhaustion,” “excitement,” “hysteria,” “homosexuality,” “compulsive onanism” (masturbation), and the like. And it’s well-documented that in the days of Jim Crow, two patients, one white and one black, with nearly identical presentations would often be given different diagnoses: the white patient was more likely to be called manic-depressive, while the patient of color was more likely to be called schizophrenic, the former being seen as more socially acceptable than the latter.

I wish I could say that the taxonomic parameters of my profession have become entirely objective and quantifiable, but that’s not true. Oh, certainly we’ve made strides, but the rendering of psychiatric diagnosis remains as much (subjective) art as science to this day.

When I was in training, viral hepatitis was classified as “A,” “B,” and “non-A-non-B” (that last being the grab bag for everything infectious that messed up the liver but was neither hepatitis A nor hepatitis B). Now, there are add’n subsets of hepatitis – “C,” “D,” “E,” possibly others – that were not even imagined when I was at the University.

Extrapolating that phenom, there is no reason to suspect that as we learn more about mental illness, the same parsing of diagnoses into presently unknown subsets will also occur.

I wish both Professor Nash and the conference speaker well in light of that with which they have struggled. But I have my doubts as to whether the two of them actually share the same condition.

[Have an idea for a post topic? Want to be considered for a guest-author slot? Or better, perhaps you’d like to become a day-sponsor of this blog, and reach thousands of subscribers and Facebook fans? If so, please contact the Alienist at vadocdoc@outlook.com]

[Copyright 2013 @ The Alienist’s Compendium]