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kleenexwomanBy Rachel Weisserman
Fictional characters make for confusing case studies; this is the function of narrative. What would in real life be a perfectly straightforward diagnosis of a single disorder becomes an exercise in metatextual analysis, as symptoms are often introduced to accommodate or expedite the plot, with little or no regard for medical accuracy. In most cases, this can be attributed simply to poor research; the author’s intent can be deduced from the use of clichés and misconceptions surrounding whichever disorder it is they were attempting to portray. However, there are still some narratives in which symptoms or aspects of psychological disorders are used consciously for symbolic effect rather than medical accuracy, which makes it significantly more difficult to disregard those aspects of the disorder which would not occur in real life or that do not fit in with the rest of the diagnosis.
The album “Tommy,” by the Who, is one of those narratives. The story deals with Tommy Walker, a child who is rendered deaf, blind, and mute from trauma when he witnesses the murder of his father, a war hero, by his mother’s lover. He retreats into a world of his own devising, interacting with the outside world only to play pinball and stare into a mirror. He is only “freed” from his prison of sensory deprivation and non-communication when his mother, fed up with his inability to relate to her or to his surroundings, smashes the mirror. In this way, psychosomatic symptoms of blindness, deafness, and mutism, stemming from conversion disorder, are used as symbols to convey the themes of the alienation and self-examination of the postwar generation.
Conversion disorder is a type of post-traumatic stress syndrome in which emotional or physical stress is manifested in the client as “an alteration or loss of physical functioning without evidence of damage to tissues” (Kellner, xi). Classically, this was thought to be an expression of stress through the subconscious, which repressed the emotional effects of stress, redirecting them to apparently symbolic physical complaints. Paralysis, for example, would suggest that a client felt somehow helpless or restrained to prevent their trauma; physical pain in various areas of the body would “not conform to well-known patterns...rather, it follows distribution conforming to the client's conventional idea of the pertinent anatomy and his body image” (Weintraub, 58).
The event that triggers Tommy Walker’s sensory malfunction is his witnessing of the death of his mother’s lover at the hands of his father, who was thought to be dead. This is the key to the diagnosis of conversion disorder, and the only thing that differentiates it from being associated with “the contemporary fascination with childhood autism” (Sullivan, 43-60). Indeed, many other elements of the story suggest autism rather than simple conversion disorder, both symbolically and literally; the complete isolation that Tommy experiences is often thought to be a symbol for the social and emotional isolation that autistic children experience, and Tommy’s single-minded genius at pinball is often taken as a sign of the savant-like talents common in autistic children.
The trauma of witnessing the death is not what shapes his ailment; rather, it is his mother and step-father repeating
You didn’t see it
You didn’t hear it
You won’t say nothing to no one, never in your life
that induces Tommy’s deafness, blindness, and mutism. This elaborate trigger is also the stumbling block for anyone seeking a conventional diagnosis, and the question “Is it really possible to yell at somebody so aggressively that you make him lose his senses?” (Knopper, 69) has been debated by many a critic.
This is where one would suppose the symbolism in the story to supersede any real-life psychological implications; indeed, the symptoms of hysterical conversion are traditionally thought to occur without requiring “the intervention of a suggested idea” (Trimble, 101). The repetition serves a purely symbolic function, meant to emphasize the neglectfulness of the parents.
Cases of conversion disorder have been difficult to diagnose in the past, usually because of the way the symptoms mimic real-life diseases or injuries. With the advent of more sophisticated diagnostic equipment and more exacting, empirical standards for independent diagnoses, hysterical reactions and other psychosomatic disorders have been easier to separate from purely physical injuries or disorders.
The results from Tommy’s diagnosis are very similar to other, real-life diagnoses of conversion disorder:
He seems to be completely unreceptive
The tests I gave him show no sense at all
His eyes react to light; the dials detect it
He hears but cannot answer to your call.
Blindness or other visual impairment is a common symptom of conversion disorder. It is also one of the most easily diagnosed psychosomatic disorders, as unlike an aching or immobile limb, the eye can be observably stimulated. “In a truly blind eye, the pupil is dilated and unreactive. If a small amount of vision is preserved, then the client will react to light feebly” (Weintraub, 76).
Psychosomatic deafness and mutism are more difficult to diagnose. “When deafness occurs in childhood, it may have selective elements, i.e. it only occurs with certain people or under certain circumstances” (Weintraub, 83). Mutism falls under these restrictions as well; problems often disappear under clinical scrutiny, and only surface once the client is away from the ameliorating influence of a doctor.
Tommy’s mutism and deafness do not disappear, however; in addition, the doctor in the story uses an ill-defined machine to determine the state of Tommy’s aural nerves and vocal cords, rather than a simpler hearing test or oral questioning. Still, the diagnosis comes up the same:
His eyes can hear, his ears can see, his lips can speak
All the time the needles flick and rock
No machine can give the kind of stimulation
Needed to remove his inner block.
Treatment of conversion disorder has proved to be very difficult, usually relying on intense therapy for the underlying psychological problem rather than any physical rehabilitation. The therapist’s main goal in this case is to first move the client towards an awareness of their own psychosomatic block, causing a catharsis that will allow the client to express their trauma consciously and emotionally; at this point, the pain or sensory malfunction is thought to disappear. This transition must be handled with respect; a therapist that merely informs the client that their symptoms are “all in their head” is likely to confuse and upset a client, leading to a deterioration of the client’s health and possibly additional symptoms. In more tenacious cases, treatments that make use of the placebo effect may be very useful. Various psychologists have prescribed treatments such as mild electric stimulation, hypnosis and the power of suggestion, or simple sugar pills in order to diminish and eventually eradicate the symptoms. In either case, once the physical symptoms have gone away, the client can no longer use them as a “pressure valve” and must deal with their emotions in a more traditional therapeutic setting.
The nature of Tommy Walker’s “miracle cure” does not use this form of therapy. The only thing that captures his attention, besides pinball, is a mirror which he stares into; his trance is broken and his sight restored when his mother, angry with his lack of communication, shatters the mirror he is looking into. Again, the symbolic nature of the story comes into play; the mirror may very well be a muddled symbol for the subconsciously self-deluding nature of psychosomatic and conversion disorders, its shattering symbolizing the “breakthrough” the client must make.
“Tommy” concludes with the eponymous pinball wizard breaking out of his psychosomatic shell to share his new knowledge with “followers,” who later rebel and smash the pinball machines he uses to impart his wisdom to them. Like a therapist faced with his own traumatized client, he tries to lead his followers to a higher understanding of their minds and the way they are affected by the stress factors inherent in their own lives. Such knowledge may be completely apparent to a trained psychologist or a recovered client, but to someone terrified or tormented by a sudden and mysterious pain or paralysis, the idea that their suffering is “all in their head” may be unthinkable. A therapist must help the client deal with the problem by treating their symptoms with the gravity shown a genuine physical disorder, or by allowing the patient to realize the psychosomatic nature of their symptoms on their own.
Knopper, Steve. “The Who, Tommy.” Kill Your Idols: A New Generation of Critics Reconsiders the Classics. New York: Knopf Books, 2004.
Kellner, Robert , M.D., Ph.D. Psychosomatic Syndromes and Somatic Symptoms. American Psychiatric Press, 1991.
Sullivan, William P. “Bartleby and Infantile Autism: A Naturalistic Explanation.” The Bulletin of the West Virginia Association of College English Teachers, 3.2 (Fall 1976), 43-60.
Trimble, Michael R. Post-Traumatic Neurosis: From Railway Spine to the Whiplash. London: Wiley Medical Publications, 1981.
Weintraub, Michael. Hysterical Conversion Reactions. New York Medical College: Spectrum Publications, 1983.
Someday I'll write a much better paper than this. But now I'm late for class.
