Re: Alexandra and her Health Part 2

[helenazar]

I have always wondered about her ability to work in the hospital as well.  How was it that she could handle that so well?

In fact, being able to help others who were worse off than her made Alexandra feel better, it soothed her in a way. It's almost as if it made her forget about her own problems by concentrating on the miseries of others and helping them. I think it may have been a way for her to cope with her anxieties. As far as her numerous illnesses, it seems that she may have been what we would today call a "hypochondriac", which really means a severe anxiety disorder, which manifested itself as physical illnesses, some real, some imagined, but still real to her. I don't think this is uncommon and had she lived today, this probably would have been easily treated. 

[Louis_Charles]

FOTR discusses, albeit briefly, the relationship between Alexandra and her daughters - especially Olga and mentions the strain that sometimes occured.     

Just a reminder, we are not allowed to mention or refer to FOTR on this forum, as per the FA.

Did I miss the memo about this?

Thanks,

Simon

[Helen]

  Liz, I cannot but wonder whether you're really serious about some of the things you wrote.

Many of Alexandra's physical illnesses were not real.  They were largely physical manifestations of psychological problems (probably including the need for attention) and as such were real enough to her but not technically real physical illnesses.  Because they had no physical origin, a simpler term for them would be "faking" but, like I said, they were real enough to her.  So they existed and she took advantage of them.  Maybe even exaggerated occasionally.  She certainly was not sick all the time, but it would be fair to say she was "ill" a significant proportion of the time. 

Alix may have suffered from some stress-related psychosomatic health problems, but this does NOT mean that she "faked" symptoms; some of her health problems were of course of a physical nature. IMO, to use the word "faked" with regard to psychosomatic symptoms shows either a great lack of understanding of such health problems or is a deliberate suggestive choice of word to give a negative twist to things. 

What I find interesting is that she worked herself into fits of pain over walking past a crowd but performed seamlessly when faced with blood and gore and trapped in small operating rooms most people would consider a hell.  It's almost like an exaggerated Munchhausen's Syndrome.  She needed others to be sick for her to be healthy and to come to the rescue.       

Could you please provide solid evidence that she "worked" herself into fits of pain when walking past a crowd and that her pains were not real? The pains caused by sciatica were very real, as far as I know.

As regards her hospital work, I think one should consider that the stress this work gave her was of an entirely different nature than that of public appearances and therefore may have affected her health differently than public appearances did. Moreover, she may have considered this hospital work as more meaningful than appearing at balls and theatre performances. Care for the suffering had been something she had taken a sincere interest in since her youth, something she also saw as a Christian duty. This may have influenced her ability to work too. Yes, it's true that helping someone who is worse off than oneself can be rewarding and can even put one's own problems in a different perspective, but references to Munchhausen's Syndrome, no, even exaggerated Munchhausen's Syndrome, make no sense at all.

I wouldn't describe her work at the hospital as something she "performed seamlessly".  Yes, she did work at the hospital for a while, but then her health would fail and she would be absent from the OR for days or weeks, so it was basically an on and off thing. That doesn't sound very "seamlessly". I do not have sufficient information about the extent to which her health was affected by what she saw at the OR, but seeing the horrible wounds of the soldiers did upset her.

As for Alexandra's letters, letters before and after the war exhibit the same nagging albeit to a lesser degree.  Obviously the stress of war hyperactivated her.  No matter how coy and loving the words, they are still demanding.  Helen, where can I find the letter in which Alexandra admits her illnesses are phantoms?

Of course I don't know which letters you've read, but I've read hundreds of letters she wrote that are not nagging at all. The specific letter from December 1913 I referred to can be found in Alix an Gretchen.

I think your use of the word  "phantoms" gives a - deliberate? - negative twist to my words and indirectly to Alix's statement. I did not say that Alix admitted that her health problems were phantoms, nor did she. She did say, however, that she knew that her heart condition was not "organic" and that her pains came from endless worries and sorrows in the preceding years.

Alexandra felt it necessary to condition her attendance of a public celebration "with great force of will, suffering severe pains."  Why would she, other than to gain attention and sympathy for her martyr like bravery, have to mention this?  Her entire family would have known about her aches and pains, mentioning them was pointless. 

I think you may have misread my previous post. It was not Alix herself who mentioned this. It was someone else who noticed it, in this particular case her brother.

But hey... enough! I don't want to spoil your fun. 

[Raegan]

Many of Alexandra's physical illnesses were not real.  They were largely physical manifestations of psychological problems (probably including the need for attention) and as such were real enough to her but not technically real physical illnesses.  Because they had no physical origin, a simpler term for them would be "faking" but, like I said, they were real enough to her.  So they existed and she took advantage of them.  Maybe even exaggerated occasionally.  She certainly was not sick all the time, but it would be fair to say she was "ill" a significant proportion of the time.

Tsarina_Liz, you clearly stated on September 19 that you believed Alexandra (the "nagging shrew" as you prefer to call her) was faking her illnesses. If you have forgotten this, I shall remind you with your quote below: 

She was a nagging shrew who I can easily picture faking a woozy spell to induce Nicholas' guilt.

Then you claimed yesterday that you that you "never meant to imply" she faked them. See below:   

I never meant to imply she faked them, they were certainly real enough to her (as letters from Botkin can attest, the heart problems etc.

Clearly, you are back peddling here.

As her "illnesses" progressed Alexandra increasingly used narcotics to control the symptoms, I don't have direct access to my books right now, but I think she was taking (excessive amounts of) some sort of narcotic and also mercury (mercury chloride?) for her heart (someone who can get to books, please feel free to write the specifics).  She was experiencing "symptoms" so often, including insomnia, she was taking the drugs on a regular basis meaning they built up in her system to the point she had to essentially overdose to obtain the desired effect.  Her body had built up a resistance.  An autopsy on her body probably would have been very interesting.

 

Tsarina_Liz, you stated that Alexandra OVERDOSED on drugs. I want to know where you pulled that from.

Alexandra required attendance by her daughters and did not like to be alone. The girls simply devised a system of serving on a rotating basis.  Yes, they loved her and she loved them but that does not mean she did not make demands of them.

How do you know Alexandra didn't like to be alone? I am quite curious about this. I have never came across anything (meaning primary sources) to suggest that she demanded that they care for her. In fact, I recall one note in A Lifelong Passion, I believe, in which Olga (yes, Olga) told her mother that she preferred to stay with her instead of joining the others. Believe it or not, Alexandra's daughters enjoyed her company.

[Louis_Charles]

In your opinion, was Alexandra's relationship with Olga ever strained? I have read letters from Alexandra complaining that her eldest daugher pays her no mind, or challenges everything her mother says. This does not negate the very real love a parent and child feel for each other, but it isn't necessary to believe that everything was always roses.

The words "nagging shrew" are inflammatory, but it seems beyond question that Alexandra nagged Nicholas regarding the conduct of the war, political appointments and the role of Gregory Rasputin.

[Raegan]

In your opinion, was Alexandra's relationship with Olga ever strained? I have read letters from Alexandra complaining that her eldest daugher pays her no mind, or challenges everything her mother says.

No, I don't believe it was ever strained. Strained is a powerful word. I firmly believe there were disagreements, that is only normal. But strained? No. And the only time I have come across the normal disagreements (which happens in any normal parent-child relationship) is the letter you mentioned, in which Alexandra complained of her daughter sulking and complaining. Alexandra wrote this letter to Nicholas during WWI, when Olga was clearly experiencing issues she had never dealt with before (such as nursing the wounded). IMO, she became irritable during the war years, so I wasn't too surprised to read that letter in the Complete War Correspondences. However, in the literally hundreds of letters that spanned three years, that is the only one in which any disagreements were brought up, at least as far as I can remember. No others stand out. So that doesn't exactly reflect a "strained" relationship.

The words "nagging shrew" are inflammatory, but it seems beyond question that Alexandra nagged Nicholas regarding the conduct of the war, political appointments and the role of Gregory Rasputin.

As Helen said, those letters were not written during a "normal" time in her life. It was war, after all. Her earlier letters to family and friends do not come across as nagging. Both Helen and myself have read dozens of her earlier letters due to our research, and her earlier letters do reflect a different person.

[Louis_Charles]

Of course, that is your impression, but they do to me; her behavior was difficult during the Rasputin and Phillipe periods as well, and they weren't (only) during wartime. Moreover, the period of the war was the first time she and Nicholas had spent significant time apart during the marriage, unleashing a torrent of letters. It strains credulity that she developed a new personality because of the war that demonstrated itself in the flood of advice she gave. Is it not more likely that she did the same verbally throughout the marriage? In the end I think it is hard to ignore the fact that Nicholas trusted her above all other advisers, and that he sided with her against the rest of the Romanov clan.

I have always wondered if her illnesses were not brought on by reaction to the strain imposed by her pathological shyness. Many people remarked upon her physical reaction to stressful public situations, namely blotchy skin. That, coupled with her disdain for society, made it easy to withdraw as much as possible into her inner family circle.

[Raegan]

Of course, that is your impression, but they do to me; her behavior was difficult during the Rasputin and Phillipe periods as well, and they weren't (only) during wartime. Moreover, the period of the war was the first time she and Nicholas had spent significant time apart during the marriage, unleashing a torrent of letters. It strains credulity that she developed a new personality because of the war that demonstrated itself in the flood of advice she gave. Is it not more likely that she did the same verbally throughout the marriage? In the end I think it is hard to ignore the fact that Nicholas trusted her above all other advisers, and that he sided with her against the rest of the Romanov clan.

I can only respond by saying what I said before, and that is her earlier letters do not resemble the WWI letters and show a much different person.

I have always wondered if her illnesses were not brought on by reaction to the strain imposed by her pathological shyness. Many people remarked upon her physical reaction to stressful public situations, namely blotchy skin. That, coupled with her disdain for society, made it easy to withdraw as much as possible into her inner family circle.

She was certainly a shy person, but her shyness didn't stop her from attending many important events in her life. Despite her pain, she did follow through much of the time. Other than that I can't really remark about what a shy person must suffer in such a situation. It just makes me feel fortunate that I am not shy. I couldn't imagine that kind of agony!

[Louis_Charles]

No, I can't either! How terrible to have physical symptons manifest because of shyness!

I guess we will have to agree to disagree, though, about her behavior during the war as being a radical personality departure for her. I might add that I don't regard her behaviors as entirely negative. Certainly the experiences with her son had left her very capable in terms of being psychically able to cope with medical war work, and her deep religiosity probably also gave her the strength she needed to perform the grueling work accomplished in the hospital.

I do think, however, that she suffered from personality disorders that were undiagnosed at the time (although the symptoms were noted by family members and court observers). Most of these were exacerbated by the need for a male heir, and then by Alexei's illness --- which Alexandra internalized as having been caused by herself. Within the confines her own understanding of the world, her actions probably seemed reasonable, but objectively they would have to be occasionally judged as irrational.

[Raegan]

I guess we will have to agree to disagree, though, about her behavior during the war as being a radical personality departure for her.

I agree to disagree.

I do think, however, that she suffered from personality disorders that were undiagnosed at the time (although the symptoms were noted by family members and court observers). Most of these were exacerbated by the need for a male heir, and then by Alexei's illness --- which Alexandra internalized as having been caused by herself. Within the confines her own understanding of the world, her actions probably seemed reasonable, but objectively they would have to be occasionally judged as irrational.

I see what you are saying, but I also try not diagnose a person I never met. It is temping to say I believe so-and-so suffered from this, but then there really is no way of knowing for sure.

Well I am going to attempt to get some sleep now, even though I am not tired. Enjoyed the discussion, and have a good night.

[helenazar]

How terrible to have physical symptons manifest because of shyness!

IMHO, this was not merely "shyness", but severe anxiety that she suffered from, which got even more aggravated as time went by (as usually happens unless treated). This may have been what partially caused her physical symptoms such as her "heart problems", because such anxiety often does. It would make a lot of sense.

P.S. I am not trying to diagnose, just my hypothesis to try to explain some things  .

[Louis_Charles]

I think it is probably a mistake to "diagnose" an historical personage the farther back one goes and the fewer the sources. But this was a woman who lived well into the 20th century, and who was the most public figure in the Empire after her husband. Her actions were described, medical records were maintained, and we have access to enough information about her to make educated speculations (hypotheses)  about her health. And of course, I used the word shyness when I meant "panic disorder". Her physical reaction to public appearances was too extreme and frequent to be simply "shyness".

[Romanov_fan]

This is an interesting debate, and I think we need to be accurate and not jump to at times rather out there conclusions not supported by the evidence we have. Alexandra undoubtedly did have some actual physical issues; and some of it was caused or aggravated by stress. It was a combination, no doubt. She was stressed more than most, and didn't or coudn't cope with all of it. Added to this, the fact she had actual health issues, it became what we know so well from the historical evidence. Alexandra certainly did not fake illness; even those who do not wish her memory well are inclined to admit this. There is no evidence at all of that. Alexandra I think never really used any health problems to avoid things; I think going out in public did cause her real distress, due to her shy nature. Today, she might have been able to work on that, perhaps if she was stuck in a public role. Then, she already faced enough things, and so she retreated from the world. She perhaps ought not to have had a public role in view of her shyness, but it is easy to understand why she avoided oublic events, even if it isn't easy to justify it.b She never used illness to avoid anything there, unless it really was illness. Generally, she wasn't known to be comfortable in public, so it was understood by her family, or at least known why she avoided public events.It doesn't do any respect to her memory, or to historical accuracy to say she faked illness.

[Rudolf_II]

FWIW (as I'm not a psychiatrist), my own personal theory is that Alexandra had avoidant personality disorder.  I bound to see it this way, though, as it's what I have too.  Thankfully, I see qualified medical professionals rather than Rasputin etc.

[dmitri]

Her own family described her as hysterical.