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History of Psychiatry, 14/2, 195204 Copyright SAGE Publications 0957-154X [200306] 14:2; 195204; 035161
a
Address for correspondence: Y. G. Papakostas MD, Athens University Medical School, Eginition
Hospital, 72-74 Vas Sophias Ave, 11528 Athens, Greece. E-mail: gnchrist@compulink.gr
b
Department of Medical History, Athens University Medical School, Greece.
c
Department of Psychiatry, Harvard University Medical School, Massachusetts General Hospital
and McLean Hospital, Boston, USA.
d
Department of Psychiatry, Athens University Medical School, Greece.
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Among the nymphs chased by Pan, Pitys escaped him only by being
metamorphosed into a fir tree, Syrinx became a reed, and Echo became an
echo. These are just a few examples indicating that the victims of the god
Pan did worry about additional attacks, and the implications or the
consequences of these attacks, thus changing their behaviour as do patients
with the DSM-IV diagnosis of panic disorder.
Pan, however, was not that bad. He was also full of spirit, amorous and
easy-going (Graves, 1960). Ley (1992) describes Pan in a more sophisticated
and sympathetic way:
A clever and mischievous fellow who frequently used disguises to mask
his true identity . . . Although Pan often wore disguises that aided him in
his cruel and mischievous behavior, he was a safeguard for those who
believed in him, for those who saw him for what he was a complex and
many-sided figure.
After all, Pan possessed no weapons for his defence, other than his appearance
and his cry. The magnitude and the seriousness of his threat, if any, depend
entirely on the recipients perception of the threat, as Pans weapons cause
no harm by themselves. It is obvious then that this feature of weapon-
lessness harmoniously stands for the DSM-IV requirement that panic is not
due to a medical or psychiatric illness, in striking contrast to what the victims of
panic believe when experiencing such noisy symptoms.
This brief comparative evaluation thus reveals remarkable similarities
between the DSM-IV defined panic disorder and the afflictions induced by
Pan, suggesting that the mythological concept of panic encapsulates all the
particulars of this specific anxiety state, as currently defined. Awareness of
the mythological origins and characteristics of the terms panic attack and
panic disorder may enhance clinicians understanding of this condition
and its differences from other forms of acute anxiety or from more chronic or
diffuse background anxiety states.
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Closing remarks
Although Pan was declared dead by Plutarch, this may not be so. Barlow
maintains that Pans power is experienced daily by millions. In fact, panic
may be so common, so widespread and so much a part of our experience that
we have managed to overlook its importance (Barlow, 1988). Klein (1964,
1993, 1996; Klein and Fink, 1962) and modern psychiatry (APA, 1980) have
re-instituted Pans name, paying tribute to the gods complex involvement with
mens affairs. One might wonder why the diagnostic label of panic had to
wait for so many years before its official and accidental psychiatric use, just
twenty years ago. Could it be because Pan frequently used disguises to mask
his true identity? (Ley, 1992).
Pan may not be dead, in spite of Graves statement that Pan is the only
god who has died in our time, for, as Graves realizes, the sailor Thamus may
have misheard the ceremonial lament: the all-great Tammuz2 is dead!
(Thamus Pan-megas Tethnece) as Thamus, Great Pan is dead (Graves,
1960). In any case, Pan, like Narcissus, Oedipus and Adonis has been
immortalized through the widespread use of his name in modern psychiatry.
ENDNOTES
1. Gilles: he who migrates; Petit Larousse Illustre (Paris, 1914).
2. Tammuz: the king of Egypt residing in Thebes.
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