Stress Illness and Arthur Miller (2)

Here we continue the discussion from the last post of Arthur Miller’s play Broken Glass which he wrote at age 78.  The play with my commentary will be broadcast the weekend of June 18-19 on many NPR stations around the US and is available on the web site of the LA Theatre Workshop.  See the last post for links.

Lead character Sylvia Gellburg’s paralysis from the waist down is diagnosed as Stress Illness (Psychophysiologic Disorder) by her physician, Dr Hyman.  Because of her ability to tense her leg muscles and to have sensation in some areas of her legs, the paralysis could not be due to nerve damage or disease.

Unfortunately, as with most clinicians today, Dr Hyman lacks experience diagnosing or treating this condition.  Unprofessionally, he attempts to treat her anyway because he finds her attractive.  His attempts are amateurish, expecting her to recognize and explain the hidden causes of her condition.  It is no surprise he fails to uncover the major stresses in her life and both he and Sylvia are then humiliated by her failure to improve.  Arthur Miller had similar experiences with some of the clinicians caring for Marilyn Monroe during their marriage.

It is clear that Sylvia is a beautiful and highly intelligent woman.  Before marriage she was successful in business and “enjoyed people depending on me.”  Yet at the time of the play, she has no life.  Her husband is an abusive dictator who refused to allow her to return to work after the birth of their son.  The son is now grown so she is alone at home while her husband works 10-11 hour days.  They have had no sex for decades.  Her husband would not even let her learn to drive.

When she reads about Kristallnacht (Night of Broken Glass), she sees parallels between the humiliation of the Austro-German Jews and her own subjugation to her husband’s demands.  This multiplies her personal anguish and raises fear that Austro-German Jews might acquiesce to their situation as she has done, with potentially horrifying consequences.  Unable to express her pain in words, it becomes manifest via her body in the form of  paralysis.

In the 21st century, stress-induced paralysis is rare.  Instead, when stress manifests physically it affects other areas causing, for example, muscle pain, bowel problems, headaches, swallowing difficulty, back pain and countless other symptoms not as easy to diagnose as paralysis.  It is the goal of the Psychophysiologic Disorders Association to educate medical clinicians like Dr Hyman so that millions of patients like Sylvia can get the care they deserve.