The Trainer is a play by David Wilson and Anne Aylor (with writing contributions from composer Keith Burstein ).
94-550: The Trainer is a multi-media play set in a posh gym in the basement of a gentlemen’s club, punctuated with excerpts from the (real life) opera Manifest Destiny , news footage from Gaza and inane breakfast TV programmes. It delivers a darkly comical comment on the justice system, while at the same time highlighting the struggles taking place both in Gaza and in the UK and other Western countries to defend humanity from barbarism. The play explores
188-460: A suicide bomber cell , leaving her lover (the Jewish composer Daniel) in a state of hysterical blindness due to his despair at her loss and at the state of the world. Leila and Mohammed subsequently undergo a profound change of heart and, on the eve of their suicide mission, renounce violence and reject their own bombs. However, their attempts to achieve a more peaceful resolution to their lives (in
282-509: A "village psychiatrist", who believed that his words had power. From the 13th century, women with hysteria were exorcised, as it was believed that they were possessed by the devil. It was believed that if doctors could not find the cause of a disease or illness, it must be caused by the devil. At the beginning of the 16th century, women were sexually stimulated by midwives in order to relieve their symptoms. Gerolamo Cardano and Giambattista della Porta believed polluted water and fumes caused
376-512: A CIA Man (in Afghanistan) progress through the next developments in the drama. While Daniel and Leila call out to the memory of each other (Aria: "So cold on this mountain top" and duet: "Oh Daniel!"), Mohammed, captured by American forces, is beaten by the CIA Man, but embraces his torturer and pledges loyalty (Duet: "Shall we bugger you to save you?"). Leila recalls how European-Americans destroyed
470-466: A conversion diagnosis. Even if there is a clear antecedent trauma or other possible psychological trigger, it is still not clear exactly how this gives rise to the symptoms observed. Patients with medically unexplained neurological symptoms may not have any psychological stressor, hence the use of the term "functional neurologic symptom disorder" in DSM-5 as opposed to "conversion disorder", and DSM-5's removal of
564-773: A fictionalised version of the events of the trial, in parallel with a separate plot strand similar to one used in Manifest Destiny (that of an educated Palestinian woman with a Jewish lover, driven towards acts of violence in response to the state violence demonstrated in the Middle Eastern conflicts of the late 20th and early 21st centuries). The Trainer premiered at Oxford House, London, in March 2009. Actors involved included Corin Redgrave , Tim Pigott-Smith and Lebanese-American actress Jana Zeineddine. Following rewrites, The Trainer
658-540: A highly noted psychologist during the early 20th century, argued that symptoms arose through the power of suggestion, acting on a personality vulnerable to dissociation . In this hypothetical process, the subject's experience of their leg, for example, is split off from the rest of their consciousness, resulting in paralysis or numbness in that leg. Some support for the Freudian model comes from findings of high rates of childhood sexual abuse in conversion patients. Support for
752-416: A lack of appropriate care, and suffering for the patients. Eliot Slater , after studying the condition in the 1950s, stated: "The diagnosis of 'hysteria' is all too often a way of avoiding a confrontation with our own ignorance. This is especially dangerous when there is an underlying organic pathology, not yet recognised. In this penumbra we find patients who know themselves to be ill but, coming up against
846-518: A lack of sex causes complications in the uterus. Many Greeks believed it could be prevented and cured with wine and orgies . Hippocrates argued that a lack of regular sexual intercourse led to the uterus producing toxic fumes, causing it to move in the body. Therefore, he argued, all women should be married and enjoy a satisfactory sexual life. Donald Capps argues that the diseases Jesus allegedly healed , such as paralysis and blindness, were actually forms of conversion disorder. He describes Jesus as
940-558: A limitation in sexual functioning that was included in the DSM-4 was removed in the DSM-5 as well. The ICD-11 classifies conversion disorder as a dissociative disorder with unspecified neurological symptoms. Conversion disorder, originally known as Hysteria and now known as Functional Neurologic Symptom Disorder , presents symptoms following exposure to a certain stressor, typically associated with trauma or psychological distress . Usually,
1034-414: A literature review of 121 studies established that this was not true, with publication bias the most likely explanation for this commonly held view. Although agitation is often assumed to be a positive sign of conversion disorder, release of epinephrine is a well-demonstrated cause of paralysis from hypokalemic periodic paralysis . Misdiagnosis does sometimes occur. In a highly influential study from
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#17331142056781128-541: A medical explanation for the conditions cannot be found. Symptoms of conversion disorder usually occur suddenly. Conversion disorder is typically seen in people aged 10 to 35, and affects between 0.011% and 0.5% of the general population. Conversion disorder can present with motor or sensory symptoms including any of the following: Motor symptoms or deficits: Sensory symptoms or deficits: Conversion symptoms typically do not conform to known anatomical pathways and physiological mechanisms. It has sometimes been stated that
1222-550: A mother" for "the children of Arabia." (Duet: "I feel so uncertain") Her moment of conscience puts her into a brief moral conflict with the Director, who states that Arabian resources "belong to the world" and that America, on behalf of the world, must "rescue" those resources with war as the necessary tool. He sweeps aside the President's protests – claiming that the war will last beyond her term of office anyway – and insists that she signs
1316-470: A study showing that they also occur in neurological disease. One such symptom, for example, is la belle indifférence , described in DSM-IV as "a relative lack of concern about the nature or implications of the symptoms". In a 2006 study, no evidence was found that patients with functional symptoms are any more likely to exhibit this than patients with a confirmed organic disease. In DSM-V, la belle indifférence
1410-471: A traumatic or stressful event. There are certain populations that are considered at risk for conversion disorder, including people with a medical illness or condition, people with personality disorders or dissociative disorders . No biomarkers have yet been found to support the idea that conversion disorder is caused by a psychiatric condition. There has been much recent interest in using functional neuroimaging to study conversion. As researchers identify
1504-401: Is a functional disorder that causes abnormal sensory experiences and movement problems during periods of high psychological stress . Individuals with CD present with highly distressing neurological symptoms such as numbness , blindness , paralysis , or convulsions , which are not consistent with a well-established organic cause and can be traced back to a psychological trigger . It
1598-403: Is a place of debate... What we wanted to show is that terrorists are human beings, with the same emotions as the rest of us. While it's impossible to sympathise with terrorism, I think we have to, for the sake of the future, try and understand it... We wanted to show that potentially we are all suicide bombers if there is a cause." Burstein added "Opera is peculiarly able to X-ray issues and X-ray
1692-521: Is a psychological stressor. The diagnostic criteria for functional neurologic symptom disorder, as set out in DSM-5, are: Specify type of symptom or deficit as: Specify if: Specify if: Conversion disorder presents with symptoms that typically resemble a neurological disorder such as stroke , multiple sclerosis , epilepsy , hypokalemic periodic paralysis , or narcolepsy . The neurologist must carefully exclude neurological disease, through examination and appropriate investigations. However, it
1786-677: Is an opera composed by Keith Burstein with an English libretto by Dic Edwards . The opera is notable for dealing with the subject of Islamic suicide bombers , and with the ramifications of both the Middle Eastern conflict and the War on Terror . Set in the present day or "near-future", the complex plot centres on a harrowing journey through the War on Terror by the Palestinian poet Leila who—along with her friend Mohammed—is radicalised and drawn into
1880-456: Is an attempt to describe such a miracle. Taking as its starting point the most ardent form of contemporary violence—that of the suicide bomber—it asks us to contemplate a path, a journey of the soul, on which these 'martyrs' are transformed by the power of love. Their grievances remain, their passionate demand for justice remains, but their weapon turns from war to peace." In interviews with Reuters, Edwards has stated "I've always believed theatre
1974-434: Is her true duty to Islam . Declaring his love, Mohammed attempts to dissuade her from her course. (Song: "Not yet, Leila, not yet.") Rejecting Mohammed's adoration, Leila in turn realises that she has confused her own passion for the cause with her friendship with Mohammed, and that she is still in love with Daniel. (Duet: "I am confused – my passion is to fight.") Abandoning her suicide mission, Leila leaves both Mohammed and
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#17331142056782068-458: Is not addressing the problem. To be a suicide bomber is an act of despair; there's nothing more useless or hopeless." Leila, a Palestinian Arab poet, lives in London with Daniel Xavier, a British Jewish composer. In addition to being lovers, the two are artistic collaborators, as Leila is writing a libretto for Daniel's music. However, their partnership is threatened by the pressures of world events and
2162-411: Is not uncommon for patients with neurological disease to also have conversion disorder. In excluding neurological disease, the neurologist has traditionally relied partly on the presence of positive signs of conversion disorder, i.e. certain aspects of the presentation that were thought to be rare in neurological disease but common in conversion. The validity of many of these signs has been questioned by
2256-462: Is now imprisoned in Camp X-Ray . (Aria: "When I betrayed Leila") Scene 1 – Camp X-Ray, Guantanamo Bay (Leila's cell) "The War On Terror has by now provoked many stage works, many commentaries, many biting satires. But all that seemed important to me was to look straight into the heart of darkness and, like a magician pulling a rabbit from a hat, to pull out light… My motive began as outrage, to tell
2350-812: Is often thought that the frequency of conversion may be higher outside of the West, perhaps in relation to cultural and medical attitudes, evidence of this is limited. A 2007 community survey of urban Turkey found a prevalence of 5.6%. Many authors have found occurrence of conversion to be more frequent in rural, lower socio-economic groups, where technological investigation of patients is limited and people may know less about medical and psychological concepts. In recent surveys of conversion disorder, females predominate, with between two and six female patients for every male. Some research suggests however that this gender disparity may be confounded by higher rates of violence against women. Conversion disorder may present at any age, but
2444-549: Is only possible to those who come to their task in a spirit of humility. In the main the diagnosis of 'hysteria' applies to a disorder of the doctor–patient relationship. It is evidence of non-communication, of a mutual misunderstanding ... We are, often, unwilling to tell the full truth or to admit to ignorance ... Evasions, even untruths, on the doctor's side are among the most powerful and frequently used methods he has for bringing about an efflorescence of 'hysteria'". The onset of conversion disorder often correlates to
2538-588: Is paralyzed by his loss of Leila, whose unfinished poem on the struggle for freedom and justice was his inspiration. Scene 2 – Palestine "I think we are too unwilling to think about terrorists and their motives seriously. Most people, even enlightened and liberal ones, still think that suicide bombers are evil, mad and totally fanatical. But maybe it's more a case of normal people whose values and existence are threatened. I don't think we can allow ourselves to see Islamic fundamentalists simply as enemies… An opera can penetrate contemporary events emotionally and lay bare
2632-474: Is rare in children younger than ten or in the elderly. Studies suggest a peak onset in the mid-to-late 30s. The first evidence of conversion disorder dates back to 1900 B.C., when the symptoms were blamed on the uterus moving within the female body. The treatment varied "depending on the position of the uterus, which must be forced to return to its natural position. If the uterus had moved upwards, this could be done by placing malodorous and acrid substances near
2726-505: Is right that opera should take on such subjects" and noting that Burstein's music was "more melodic than most modern opera." On EdinburghGuide.com , Alex Eades commented " Manifest Destiny will haunt your soul for many a day. Of all the performances based around terrorism this year, this is the one to see. A miracle of a show that is sometimes beautiful and sometimes horrible. It is, however, always unforgettable." The Scotsman commented "Operatic themes do not come more epic than this." In
2820-420: Is stronger than hatred." The Daily Telegraph' s David Gritten described the opera as "rigorous and high minded, with a story in the environs of Greek tragedy" and praised Burstein's ambition and the music (which the reviewer found "mournful" and "affecting"), but attacked Edwards' libretto as "stilted" and the political content as "banal and fatally one-sided," In a combined feature/review of political works at
2914-411: Is that the symptoms may have been evolutionarily advantageous during warfare. A non-combatant with these symptoms signals non-verbally, possibly to someone speaking a different language, that she or he is not dangerous as a combatant and also may be carrying some form of dangerous infectious disease . This can explain that conversion disorder may develop following a threatening situation, that there may be
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3008-481: Is the most common treatment, with a 13% improvement rate. Empirical studies have found that the prognosis for conversion disorder varies widely, with some cases resolving in weeks, and others enduring for years or decades. There is also evidence that there is no cure for conversion disorder, and that although patients may go into remission they can relapse at any point. Many patients can get rid of their symptoms with time, treatments and reassurance. Information on
3102-540: Is this? It’s not poetry.") Her spirit all but broken, Leila pleas for an end to her suffering (Aria: "Let me die"). Despite himself, the Jailer is moved to a kind of remorse: declaring "no, I will save you" he unbinds her and goes in search of water. Left alone, Leila sings of how war has despoiled her homeland and its people (Aria: "There is a tree in my mother’s garden") Conversion disorder Conversion disorder ( CD ), or functional neurologic symptom disorder ( FNsD ),
3196-429: Is thought that these symptoms arise in response to stressful situations affecting a patient's mental health or an ongoing mental health condition such as depression . Individuals diagnosed with conversion disorder have a greater chance of experiencing certain psychiatric disorders such as anxiety , depression , and personality disorders compared to those diagnosed with neurological disorders . Conversion disorder
3290-400: Is unclear what proportion of the unexplained symptoms are actually due to the disorder. In 1976, large scale psychiatric registers in the U.S. and Iceland found incidence rates of 22 and 11 newly diagnosed cases per 100,000 person-years, respectively. In 2002, some estimates claim that in the general population, between 0.011% and 0.5% of the population have conversion disorder. Although it
3384-457: The 2005 Edinburgh Festival Fringe , with a cast of four. The Observer announced it as "undoubtedly the most controversial production" of the festival," (Observer of 24 July) and it was flagged by both The Independent and The Times as one of the five top classical music events to see in Edinburgh that year. Excerpts from the opera were subsequently performed at public concerts – notably, part of
3478-574: The Hackney Empire theatre in May 2009. In productions to date, the opera's eight characters have been performed by singers doubling or tripling roles. (adapted and condensed from theatre programme from 2005 Edinburgh production, and by referencing the privately circulated DVD recording of the opera, also from the Edinburgh production) The action takes place variously in London , Palestine , Afghanistan ,
3572-489: The Israelis , whom they see as their oppressors. (Song and chorus: "What we are doing may seem monstrous."). Omah then leaves to carry out his suicide mission. However, Mohammed has fallen in love with Leila, and the sight of her preparing for her own suicide mission finally completes a change in him. He decides that her power of creativity is a greater power than that of violence; and that her poetic vision, not her power to kill,
3666-488: The London Evening Standard , Keith Burstein sued Associated Newspapers (the newspaper's parent organisation) for libel in 2005. He did so on the grounds that the review (although it did not specifically contain the words 'glorify' or 'glorification') claimed that he had glorified terrorism via the content of the opera, and that this was not only libellous but left him open to the risk of state prosecution under both
3760-566: The Native Americans for the sake of gold with their " Manifest Destiny " policy. She fears that a similar fate awaits the Arabs for the sake of their oil, and pleads that the Arabs only want to live in "the beauty of their beliefs." (Aria: "For a century Western nations have brought terror to Arabia") In their separate worlds, Daniel, Leila, Mohammed and the CIA Man muse on the situation (Quartet: "Parallels"). Mohammed then decides to betray Leila to
3854-618: The Oval Office of the White House , the newly elected US President is seen celebrating with her CIA Director after the President's Inaugural Ball. (Duet: "The Oval Office!") They muse idly about their global ambitions. The Director shocks the President by telling her she can become "the first American Emperor." (Duet: "So where do we begin, Mrs President?") Scene 2 – Afghanistan/London In parallel scenes, Daniel (in London) and Leila, Mohammed and
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3948-492: The Scotsman On Sunday , Michael McManus was particularly complimentary, comparing Manifest Destiny to Michael Tippett ’s A Child of Our Time and praising the "brave, touching and timely work" as "a dazzling, dark opera ... affecting, bold, potent and perhaps most importantly of all, packed with melodic invention… Mahlerian harmonies and rhythmic patterns, a gorgeous waltz, and a cynical tango. … Time and again – as in
4042-684: The White House in Washington, D.C., and Camp X-Ray , Guantánamo Bay . Scene 1 – London "Our starting point was: where do suicide bombers come from? They don't just drop from the sky. This whole thing goes back way before 9/11; the jihad began in Afghanistan with the Russian invasion and then it was carried on with the Americans in Saudi Arabia during the first Gulf War . To say they are mindless people
4136-421: The 1960s, Eliot Slater demonstrated that misdiagnoses had occurred in one third of his 112 patients with conversion disorder. Later authors have argued that the paper was flawed. A 2005 meta-analysis has shown that misdiagnosis rates since that paper was published are around four percent, the same as for other neurological diseases. The psychological mechanism of conversion can be the most difficult aspect of
4230-681: The 2005 Fringe, the Sunday Herald's Iain McWhirter hailed Manifest Destiny as a "scintillating if flawed opera – with a witty and surprisingly melodic neo-classical score" but argued that "the politics are sometimes risible (and) the ultimate message, that love can triumph over religion and bring Jew and Muslim together, is unconvincing. Nevertheless, Manifest Destiny is a considerable piece of work, dealing with important themes, which demands to be heard." Anna Picard, in The Independent on Sunday ,
4324-452: The Edinburgh performances, the opera was extensively rewritten and restaged in London as Manifest Destiny 2011 . Seeking collaborators for an opera taking the "War on Terror" as its subject, Burstein advertised for a librettist. He advertised for a librettist via Artists Against The War. In late 2002, the post was filled by controversial Welsh playwright Dic Edwards , and the two subsequently wrote Manifest Destiny together, completing
4418-679: The Guantanamo Bay prison scene from Act 3. The critical response to Manifest Destiny was widely varied. The various productions gained a great deal of press attention, much of it relating to the subject matter, including coverage by Reuters, the BBC and Sud Deutsche Zeitung . For the 2003 Tricycle Theatre production, the Observer ' s Anthony Holden described Manifest Destiny as a "worthy piece" but also commented that "for all its static, repetitive atmospherics, Burstein's melodic, neo-classical score –
4512-640: The US forces (Duet: "I can give you a leading terrorist"). Privately, he reasons that this will save her life and her soul: if she is still intending to be a suicide bomber, imprisonment will ensure that she cannot kill either herself or others. However, the decision causes him anguish and doubt (Aria: "To be blind…") In London, Daniel sings of his continuing faith in Leila (Aria: "Leila, redeemer of my memory"). Scene 3 – The White House, Washington DC The President expresses misgivings about attacking Arabian states, and fears "as
4606-507: The above treatments. This may include the following: There is little evidence-based treatment of conversion disorder. Other treatments such as cognitive behavioral therapy , hypnosis , EMDR , and psychodynamic psychotherapy , EEG brain biofeedback need further trials. Psychoanalytic treatment may possibly be helpful. Most studies assessing the efficacy of these treatments are of poor quality and larger, better controlled studies are urgently needed. Cognitive behavioral therapy (CBT)
4700-477: The authorization to send American forces into battle. (Duet: "Mrs President – the Arabians have oil"). As the President signs, she and the Director are interrupted by the sudden arrival of Mohammed, who has convinced his captors of his value as a double agent. He is duly dispatched to Guantanamo Bay by his new American masters, who believe that he will be able to extract secrets from the detainees there. Carried away by
4794-407: The blank faces of doctors who refuse to believe in the reality of their illness, proceed by way of emotional lability, overstatement and demands for attention ... Here is an area where catastrophic errors can be made. In fact it is often possible to recognise the presence though not the nature of the unrecognisable, to know that a man must be ill or in pain when all the tests are negative. But it
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#17331142056784888-725: The bomber cell, choosing to pursue her spiritual struggle further afield – in Afghanistan. Alone, Mohammed admits that his love of Leila is more powerful than his commitment to martyrdom. (Aria: "This pain is too real – greater than all the grief of Islam"). He turns away from insurgency and terrorism, realising that he has the alternative of following a peaceful course drawn from the heart of his Islamic beliefs. Mohammed decides to follow Leila to Afghanistan and perhaps save her from herself ("for Islam and for Man.") Defusing and destroying his suicide bomb, he declares "I love life more than I love death." Scene 1 – The White House, Washington DC In
4982-402: The cell and pursue martyrdom as part of her personal jihad . Meanwhile, a despairing and angry Daniel is gradually going blind. He considers his condition to be a response to the trauma of world events, now dominated by a clash between the West and the retaliatory terrorism of the 'third world' whose spiritual values are perceived to be under threat. As the opera begins, Daniel angrily denounces
5076-436: The clinician should still exclude any other organic disorders through thorough examination. Sexual dysfunction and pain are also symptoms of conversion disorder, but if a patient only has these symptoms, they should be diagnosed with sexual pain disorder or pain disorder . Conversion disorder is now contained under the umbrella term functional neurologic symptom disorder (FNsD). In cases of conversion disorder, there
5170-420: The dead Leila's poetry as a completed libretto, which he brings back to Daniel to set to music (effecting a symbolic reconciliation between Jewish and Palestinian cultures in spite of realpolitik interests and personal tragedy). Manifest Destiny has attracted a large amount of press attention due to its themes, content and subject matter—including scenes showing the preparations for a suicide bomb raid and
5264-477: The disorder. Freud's model suggested the emotional charge deriving from painful experiences would be consciously repressed as a way of managing the pain, but that the emotional charge would be somehow "converted" into neurological symptoms. Freud later argued that the repressed experiences were of a sexual nature. As Peter Halligan comments, conversion has "the doubtful distinction among psychiatric diagnoses of still invoking Freudian mechanisms". Pierre Janet ,
5358-616: The dissociation model comes from studies showing heightened suggestibility in patients with conversion disorder. Critics argue that it can be challenging to find organic pathologies for all symptoms, and so the practice of diagnosing patients with such symptoms as having hysteria led to the disorder being meaningless, vague and a sham diagnosis, as it does not refer to any definable disease. Throughout its history, many patients have been misdiagnosed with hysteria or conversion disorder when they had organic disorders such as tumors , epilepsy , or vascular diseases . This has led to patient deaths,
5452-452: The effects of those events on their own beliefs and loyalties. Leila's outrage at the iniquities of the post- 9/11 world and the growing 'War On Terror' have led into pro-Palestinian political activism. From this, she has moved into a form of militant Islamism: to this end, she has established links with a suicide bomb cell in Jerusalem run by her friends Omah and Mohammed. She intends to join
5546-545: The events that led to this crossroads. These included the political rise of Ariel Sharon , the Palestinian Intifada ; the election of George W. Bush as American president (with the apparent complicity of the Florida Supreme Court ); the atrocities of 9/11 and the subsequent atrocities in Afghanistan, Iraq and across the world. (Aria: "These?") Daniel's sense of responsibility intensifies. His ability to act
5640-509: The face of a brutal and cynical war campaign involving the President of the United States of America and her Director of CIA ) result in them becoming further—and fatally—entangled in the conflict when Mohammed takes the fatal step of "saving" Leila by turning her over to American forces, leading to her internment and subsequent death in Camp X-Ray . The plot is resolved when Mohammed retrieves
5734-614: The first act of Manifest Destiny was performed at the Cockpit Theatre , Marylebone, London during November 2003, directed by David Wybrow. The first full-length production was subsequently performed at the Tricycle Theatre , Kilburn, London on 27 June 2004 (produced by Corin Redgrave ). The second full-length production (also directed by David Wybrow) was staged at the St Georges West venue between 6 and 29 August 2005 as part of
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#17331142056785828-446: The frequency of conversion disorder in the West is limited, in part due to the complexities of the diagnostic process. In neurology clinics, the reported prevalence of unexplained symptoms among new patients is very high, between 30 and 60%. However, diagnosis of conversion disorder typically requires an additional psychiatric evaluation, and since few patients will see a psychiatrist, it
5922-404: The greatest operatic works – tonal resolution and emotional closure come hand-in hand" The reviewer also commented "Like so much great art, Manifest Destiny marries the personal with the political, the particular and the universal… A simple and humanitarian message shines through unambiguously; that violence begets only violence in a cycle which must be broken as an act of human will; and that love
6016-540: The gym in which Taghreed works (all of whom happen to be Judges of the Court of Appeal). After Keith Burstein and Dic Edwards ’ opera Manifest Destiny was performed at the 2005 Edinburgh Festival Fringe the London Evening Standard newspaper published a review which claimed that the opera glorified terrorism. Burstein subsequently took the newspaper to court on the grounds that this claim put him at risk under
6110-477: The hysteria phenomenon as there was no evidence to prove its existence. Sigmund Freud referred to the condition as both hysteria and conversion disorder throughout his career. He believed those with the condition could not live in a mature relationship, and that those with the condition were unwell in order to achieve a "secondary gain", in that they are able to manipulate their situation to fit their needs or desires. He also found that both men and women could have
6204-566: The incarceration and maltreatment of Leila in Camp X-Ray (the latter of which was a scene written prior to public knowledge of the events at Abu Ghraib ). An accusation in the press was the subject of a libel action ( Burstein vs Associated Newspapers ) in the British High Court . The opera has been staged twice: once at London's Tricycle Theatre in 2004 and once at the Edinburgh Fringe Festival in 2005. Six years after
6298-399: The love story between a British Jew, Josh, and his Palestinian fiancée Taghreed (who works as a fitness trainer at the gym in a London gentlemen's club). Their story is interwoven with a predominantly fact-based account of the real-life bankruptcy of British composer Keith Burstein (as the result of a libel trial relating to issues of alleged promotion of terrorism) as told by the attendees of
6392-500: The mechanisms which underlie conversion symptoms, it is hoped they will enable the development of a neuropsychological model. A number of such studies have been performed, including some which suggest the blood-flow in patients' brains may be abnormal while they are unwell. The studies have all been too small to be confident of the generalisability of their findings, so no neuropsychological model has been clearly established. An evolutionary psychology explanation for conversion disorder
6486-429: The moment, the Director announces that a new Manifest Destiny now applies to everyone ("even the bums on our campuses!") and that this is the beginning of "full spectrum dominance – pre-emptive strikes against everyone." (Trio: "Mrs P, meet Mohammed!") Mohammed's true motive for travelling to Guantanamo, however, is to seek redemption and forgiveness from Leila, who has been captured by the Americans on his information and
6580-680: The motives of the characters with absolute clarity. Operas are principally concerned with love, but also with feelings like anger, fear and confusion – all the emotions that were encompassed in the reaction to September 11... Opera needs to be reinvigorated so that people realise just how well it can deal with contemporary themes." Leila joins Omah and Mohammed in the suicide bomb cell. She finds them apparently devoted to their martyrdom, believing themselves to already be ascending towards heaven. (Trio: "We’ll give our lives to fight") Fervently chanting " we love death more than they love life ", they don explosive devices and prepare to detonate themselves amongst
6674-686: The need for a psychological trigger. The change of name in the DSM-5 also came with a change of criteria. there was a removal of connection to sexual functioning as well as relation to any other medical condition. There was also an added connection to social and occupational functioning. While conversion symptoms are not a normal responses to stress, taking measures to better manage psychological stress can help relieve symptoms. Treatments for conversion syndrome include hypnosis, psychotherapy, physical therapy, stress management, and transcranial magnetic stimulation . Treatment plans will consider duration and presentation of symptoms and may include one or multiple of
6768-441: The opera in 2003. Though critical in tone, the opera was explicitly presented as a pacifist statement. Both Burstein and Edwards took pains to stress that the opera did not endorse the actions of suicide bombers and displayed them ultimately rejecting their violent course of action. In the programme for the Edinburgh production, Burstein wrote: "The renunciation of violence in time of war will always seem miraculous. Manifest Destiny
6862-503: The opportunity of taking the case to a trial by jury. The second judgement overturned the first (while admitting that it was "very unusual" to overturn a High Court ruling for a jury hearing) and found in favour of Associated Newspapers . The result was that costs were awarded against Burstein and he was consequently forced into bankruptcy . Although Burstein subsequently took the case to the European Court of Human Rights his application
6956-500: The performers were almost universally praised by the critics, but the response to the work itself was profoundly divided. Of the reviews which dealt more substantially with the opera itself, the British Theatre Guide ' s Peter Latham described the Edinburgh production as "a powerful piece, powerfully performed. … Political opera is a very rare bird, even today, and this piece is one to be cherished," while asserting that "it
7050-572: The physical symptoms of the syndrome affect the senses or movement. Common symptoms include blindness , partial or total paralysis , inability to speak , deafness , numbness , difficulty swallowing , incontinence , balance problems , non-epileptic seizures , tremors , and difficulty walking. The symptom of feeling unable to breathe, but where the lips are not turning blue, can indicate conversion disorder or sleep paralysis . Sleep paralysis and narcolepsy can be ruled out with sleep tests . These symptoms are attributed to conversion disorder when
7144-448: The presenting symptoms tend to reflect the patient's own understanding of anatomy and that the less medical knowledge a person has, the more implausible are the presenting symptoms. However, no systematic studies have yet been performed to substantiate this statement. Inconsistent symptoms such as negative lab and imaging results and/or a significant psychiatric disorder are suggestive indicators of functional neurologic disorder . Although
7238-543: The recently passed Prevention of Terrorism Act of 2005 (which explicitly names "promotion of terrorism" as a criminal act) and the incoming Terrorism Act of 2006 (at the time, a Terrorism Bill) which featured a retrospective "glorification of terrorism" clause. The case ( Burstein vs Associated Newspapers Ltd. ) first went to the High Court and then to the Court of Appeal . The first of these hearings favoured Burstein, granting him
7332-414: The same time). A particularly damning response to the Edinburgh production was written by the London Evening Standard ' s Veronica Lee. Although she praised the cast for their performances, she described to the opera overall as "a trite affair", the music as "uninspiring, save for the odd duet" and to the libretto as "horribly leaden and unmusical". Lee concluded her review with the comment "I found
7426-527: The security services, but by their own humanity: a process of love, springing from within the peaceful teachings of Islam and triumphing over their anger and fear. In the near-future envisaged in the opera, it is Mohammed, a Jihadist committed to violent direct action, who is transformed by discovering the human-scaled, yet overwhelming nature of his love for a fellow suicide bomber (which) has so overwhelmed his emotions that he can neither let her die, nor let her or himself kill others." A promenade production of
7520-451: The soul in a way that other media do not.I hope the opera will surprise people by making the characters in this story seem to be very immediate and very real. ... There is also a symbol at the end of a possible reconciliation between Palestinians and Jews." In an article written for The Scotsman , Burstein stated"( Manifest Destiny ) imagines a scenario in which the protagonists – would-be suicide bombers – are stopped in their tracks. Not by
7614-528: The state of the world. (Aria: "O Israel") Torn between her love for Daniel and her loyalty to Palestine, Leila chooses to return to Palestine and join the suicide bomb cell. (Duet: "You’ve been crying.") Daniel attempts to persuade her otherwise but she is adamant (Duet: "Revenge is futile") and after a harrowing debate, the two part (Duet: "Now is the beginning of my world, my night."). As Daniel plunges deeper into despair, his blindness takes hold. A parade of horrific images begins to pass before his mind, mirroring
7708-434: The symptoms of hysteria. Towards the end of the century, the role of the uterus was no longer thought central to the disorder, with Thomas Willis discovering that the brain and central nervous system were the cause of the symptoms. Thomas Sydenham argued that the symptoms of hysteria may have an organic cause. He also proved the uterus is not the cause of symptoms. In 1692, in the U.S. town of Salem, Massachusetts , there
7802-456: The tango for torture, a waltz for the White House – is badly let down by Dic Edwards's libretto, which ranges from the crudest anti-American satire to the most banal, platitudinous failure to explain the appeal of politico-religious duty (i.e. suicide bombing) over love." The Sunday Telegraph described the opera as "political, prescient and unmissable". For the Edinburgh production of 2005,
7896-704: The terms of the Terrorism Acts of 2005 and 2006. The High Court found in his favour and granted him the right to take the case to a trial by jury. However, this decision was reversed in the Court of Appeal, which ordered Burstein to pay the legal costs of the London Evening Standard (some £70,000). In consequence, Burstein was bankrupted and the Official Receiver seized possession of all of his works (including Manifest Destiny ). The court case and its aftermath inspired David Wilson and Anne Aylor (in collaboration with Burstein) to write The Trainer . The play covers
7990-420: The tone depressingly anti-American , and the idea that there is anything heroic about suicide bombers is, frankly, a grievous insult." (The Sunday Herald review had made a similar comment, stating that although Manifest Destiny deserved to be heard "it won't be if the thought police get hold of it. For it undoubtedly justifies and arguably glorifies terrorism." ) Following the review of Manifest Destiny in
8084-410: The truth our Western governments were not telling us... And yet, even as these concerns formed the structure of our plot, so that outline was filled in by something else unexpectedly: by interweaving love stories, by a sacrament of compassion and divine forgiveness falling across all who strayed along this fateful path." In Camp X-Ray, Leila is beaten by a Jailer, who also mocks her writings (Duet: "What
8178-454: The woman's mouth and nostrils, while scented ones were placed near her vagina; on the contrary, if the uterus had lowered, the document recommends placing the acrid substances near her vagina and the perfumed ones near her mouth and nostrils." In Greek mythology, hysteria , a similarly described condition, was thought to be caused by a lack of orgasms, uterine melancholy, and not procreating. Plato , Aristotle , and Hippocrates believed that
8272-534: Was a reported outbreak of hysteria. This led to the Salem witch trials , where women who were accused of being witches had symptoms such as sudden movements, staring eyes, and uncontrollable jumping. During the 18th century, there was a move from the idea of hysteria being caused by the uterus to it being caused by the brain. This led to an understanding that it could affect both sexes. Jean-Martin Charcot argued that hysteria
8366-490: Was caused by "a hereditary degeneration of the nervous system, namely a neurological disorder". In the 19th century, hysteria moved from being considered a neurological disorder to being considered a psychological disorder, when Pierre Janet argued that "dissociation appears autonomously for neurotic reasons, and in such a way as to adversely disturb the individual's everyday life". As early as 1874, doctors including W. B. Carpenter and J. A. Omerod began to speak out against
8460-482: Was particularly dismissive of Manifest Destiny , describing it as "sixth-form satire", and attacking the music for "the abject narrowness of its harmonic language and the robotic word-setting." She also compared the opera unfavourably to John Adams ’ The Death of Klinghoffer (another opera dealing with terrorism and the Middle Eastern conflict, which was being revived at the Edinburgh Festival Fringe at
8554-643: Was rejected. The court case and its aftermath inspired a subsequent theatrical play, The Trainer , written by David Wilson and Anne Aylor (with co-writes by Burstein). Premiered at Oxford House, London, in March 2009, the play covered a fictionalised version of the events of the trial, in parallel with a separate plot strand similar to one used in Manifest Destiny . Actors involved in the production included Corin Redgrave and Tim Pigott-Smith who played Burstein, and further cast members included Janie Dee and Roger Lloyd-Pack.The production went on to be performed at
8648-412: Was removed as a diagnostic criterion. Another feature thought to be important was that symptoms tended to be more severe on the non-dominant, usually left side of the body. There have been a number of theories about this, such as the relative involvement of cerebral hemispheres in emotional processing, or more simply, that it was "easier" to live with a functional deficit on the non-dominant side. However,
8742-452: Was retained in the DSM-5-TR , but was renamed to functional neurologic symptom disorder (FNsD), a subset of functional neurologic disorder (FND). FND covers the same range of symptoms as FNsD, but does not include the requirements for a psychological stressor to be present. The new criteria no longer requires feigning to be disproven before diagnosing FND nor FNsD. A fifth criterion describing
8836-495: Was revived for the fundraising evening Two Plays For Gaza on May 21, 2009 at the Hackney Empire theatre in London, UK (which also featured a performance of Caryl Churchill 's play Seven Jewish Children , talks by Tony Benn and Ben Griffin, and music from Reem Kelani and hip-hop poet Lowkey ). For this production, actors Janie Dee and Roger Lloyd-Pack joined the cast. Both productions were directed by Tom Platten. Manifest Destiny (opera) Manifest Destiny
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