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This chapter first looks at Act IV, Scene 1, a room in the castle. This scene anticipates Pelléas's fate as foreseen by his father. It then next looks at Act IV, Scene 2, which presents Mélisande as symbol of resurrection as foreseen by Arkel, while Golaud's vengeance and Mélisande's hair are presented as a symbol of the Crucifixion. Next the chapter turns to Act IV, Scene 3 — a well in the park — which provides a symbol of the sacrificial lamb. Scene 4 is based on the love duet and the death of Pelléas. Finally, the chapter looks at Act IV, Scene 4, which addresses structure and proportion in the service of musico-dramatic development and emotional climax. This scene presents the “Shadows” motif and “Ecstasy” motif. The fusion of light and dark is represented by octatonic fusion of pentatonic and whole-tone sets. The scene culminates with Golaud's vengeance and the fulfillment of fate.

As we enter the third decade of the AIDS pandemic, persons with AIDS are living longer and healthier lives as a result of appropriate medical care and advances in antiretroviral therapy. In the United States and throughout the world, however, some men, women, and children with AIDS are unable to benefit from this medical progress because of inadequate access to care. A multiplicity of barriers involving economic, social, political, and psychiatric factors contribute to this lack of access. For this and other reasons, psychiatric factors take on new relevance and meaning in this stage of the pandemic (Cohen, 2008). Psychiatric disorders and distress play a significant role in the transmission of, exposure to, and infection with HIV. They are thus relevant to HIV prevention, clinical care, and adherence to treatment throughout every aspect of illness from the initial risk behavior to death. Psychiatric disorders can result in considerable suffering, from diagnosis to end-stage illness. Persons with HIV and AIDS may have no psychiatric diagnosis at all or any diagnosis described in psychiatric nomenclature (Cohen and Alfonso, 2004; Cohen, 2008). In this chapter, we provide guidelines for the diagnosis of those psychiatric disorders that are most likely to complicate and perpetuate the HIV pandemic and pose diagnostic dilemmas for clinicians. Although we introduce aspects of treatment of each disorder, please see Chapters 7, 8, 9, 10, 11, and 12 for detailed descriptions of psychotherapeutic and psychopharmacological treatment approaches to AIDS psychiatry. Consideration of a broad differential diagnosis is paramount in evaluating behavioral disorders in persons with HIV, especially when investigating medical and neuropsychiatric etiological factors related to HIV illness and its treatment. Since few persons with HIV have access to psychiatrists or other mental health clinicians, and even fewer have access to an AIDS psychiatrist, a summary of suggested key questions is provided here to aid HIV clinicians in detecting the underlying psychiatric diagnoses most frequently encountered in persons with HIV and AIDS. While these questions are by no means a substitute for comprehensive psychiatric evaluation (described in detail in Chapter 2 of this handbook), they can inform clinicians of the need for further assessment, emergency intervention, or referral to a psychiatrist.

‘How’, this chapter asks, ‘can we think a sexuality which is larval potentiality, non-volitional or authorised by self or regimes of signification, which has no before and after but is always and infinite, and which is loss of self without nihilism, an imperceptible sexuality?’ Weighing masochism against ecstasy, MacCormack shows that while the more frequently noted subject of masochism in Deleuze's philosophy has limitations with regard to becoming-imperceptible, the underexplored theme of ecstasy harbours a great potential for escaping signification. If masochism in Deleuze emerges through a web of temporal and contractual conditions, ecstasy is outside time. It introduces the unexpected and the unknown, it is an intensity that cannot under any circumstances be reduced to subjectivity and signification. If masochism is human, ecstasy is non-human. Paying attention to mysticism, the demonic and the angelical, and focusing particularly on the ecstatic experiences of Saint Teresa of Avila, MacCormack explores the functions of pain, flesh and the body in making unnatural connections and becomings.

As these words are written, the chemical we will call MDMA is a Schedule I drug. This means that MDMA (a) has no currently accepted medical use, (b) no currently accepted safety even under medical supervision, and (c) has a high potential for abuse. On the other hand, there are those who see great therapeutic potential in MDMA, and the Food and Drug Administration (FDA) has designated MDMA- assisted psychotherapy as a breakthrough therapy. We can foresee the day when it will be available by prescription. There is no doubt as to the chemical identity of MDMA, and much is known of its pharmacological effects in humans and in animals. The recreational drug commonly known as Ecstasy is more complicated. As is true for any illegal drug used by millions of people, demand for the drug has been met by persons not noted for their high ethical or manufacturing standards. Simply stated, short of chemical analysis, one can never be sure what street-bought Ecstasy is. For example, investigators at Vanderbilt University determined the contents of 1,214 tablets sold as Ecstasy. Only 39% contained only MDMA, while fully 46% were “substances other than MDMA.” Mixtures of MDMA and other drugs comprised the remaining 15%. On the other hand, sometimes in some places over the past several decades, nearly pure MDMA has been available on the illicit market. Nonetheless, a buyer of Ecstasy may ingest, rather than MDMA, drugs such as ketamine, gamma-hydroxybutyrate (GHB), cathinone, ephedrine, caffeine, or any one of the so-called designer drugs, many of which are amphetamine derivatives. A consequence of this pharmacological chaos is that many of the hazards associated with the use of Ecstasy have been uncritically attributed to MDMA. This fact has been a boon for those who would continue the Schedule I status of MDMA and a bane for those who would explore its therapeutic potential. However, in contrast with recreational use where purity of the drug is uncertain, MDMA in clinical trials is FDA approved and of known composition.

This book concludes by discussing a short pornographic novel written in the fall of 1941, which Bataille characterizes as key to understanding his theoretical text Inner Experience. Amy Hollywood, in Sensible Ecstasy, describes the opening scene of this novel as something that “looks like a classic moment of fetishization” to bolster her contention that “for Bataille, the female sex is a wound, a terrifying and beautiful mark of castration, of the emergence of life out of laceration.” This scene is crucial to assessing Bataille's representation of women, not because, as Hollywood suggests, it looks like the fetishistic drama, but precisely because it looks quite unlike it, assigning new roles and reactions to the actors, culminating in an alternate climax.

To move towards recovery after a first episode of psychosis, patients must focus on both their mental and physical health. People with a serious mental illness are usually less healthy than those without such an illness. This may be because of the illness itself, fewer opportunities for health care, or unwanted effects of the medicines taken to treat mental illnesses. People with a long-lasting mental illness sometimes also deal with other issues, such as cigarette smoking, drug abuse, unhealthy eating habits, little exercise, and having few relationships with others. Even though it can be difficult at times, living a healthy lifestyle is necessary for patients to feel better and move towards recovery. In this chapter, we discuss problems sometimes faced by people with psychosis and ways to deal with and overcome these issues. Specifically, this chapter focuses on the importance of not smoking cigarettes, staying away from alcohol and drugs, having a healthy diet, getting plenty of exercise, and having good social support from family and friends. One problem sometimes faced by people with psychosis is cigarette smoking. About one in five people in the general population in the United States (about 21%) smoke cigarettes. Fortunately, this percentage is now decreasing because of the growing awareness of the health risks posed by cigarette smoking. However, a large percentage of people with psychosis smoke. For example, most people with schizophrenia (between 50% and 90%) smoke cigarettes. What’s more, this percentage has not decreased in recent years. People with psychotic disorders also have smoking behaviors that can cause even greater harm. Some of these behaviors include smoking heavily—up to two or three packs a day—and smoking cigarettes down to the filter where the greatest concentration of nicotine is. Why are people with psychosis so likely to smoke, and to smoke so heavily? Most researchers believe that it is because of the relationship between cigarette smoking, nicotine, and the symptoms of psychosis (see Chapter 2 on What Are the Symptoms of Psychosis?). Nicotine is a drug that affects anyone who uses it. In most people, nicotine may slightly improve attention and memory.

It is Commonly Claimed that American society is crime-ridden and violent. Horrendous numbers of murders are committed, almost twice the per capita rate in 2004–05 of the nearest competitors, Switzerland, Finland, and Sweden (figure 67). The death-by-assault rates in America are over three times the nearest European comparisons, Finland, followed by Portugal. That is without question. Such mayhem cannot be due simply to gun ownership, since by some accounts the Finns and the Swiss have a higher percentage of armed households than the Americans (figure 68). Firearms ownership, though highest in the United States per capita if measured by individual citizen, is not as far beyond the European numbers as one might expect from the horror stories of South Central or the South Bronx. According to the Graduate Institute of International Studies in Geneva, Americans own 97 firearms per hundred people, the Finns 69, the Swiss 61, the Swedes 40. Another survey, published by Tilburg University in the Netherlands, the Dutch Ministry of Justice, and two United Nations Institutes, reveals that percentage-wise there are more firearms in the hands of the residents of Zurich, Vienna, Stockholm, Rome, Reykjavik, Oslo, Madrid, Lisbon, Helsinki, and Athens than in those of New Yorkers. Indeed, the burghers of Helsinki, Berlin, Lisbon, Rome, Vienna, and Zurich own proportionately as many or more handguns as New Yorkers. To the extent that gun ownership and hunting overlap, the distinctions between the United States and Europe also fade. Svenska Jägarförbundet, the Swedish Hunters Association, has a membership (200,000) that is proportionately almost twice as high as what the National Rifl e Association claims (4 million). The Schweizer Schiesssportverband (Swiss Shooting Association) has a membership (85,000) that is relatively as high as the NRA’s. Its arguments against current proposals to regulate gun ownership in Switzerland more strictly sound many of the same themes that are heard in the United States, down to the slogan about people, not guns, doing the actual killing. The smaller Pro-Tell Society defends gun ownership as part of Switzerland’s liberal tradition. In Switzerland, of course, men oft en keep their military weapons at home.

This chapter explains the musical quality of Siraj Awrangabadi’s poetry. He wrote his poems to be sung in sama`, the Sufi gatherings meant for listening to devotional music. This tradition is knows as Qawwali, and is integral to the Chishti order as its spread in the Deccan. The chapter ends by discussing Siraj’s legacy as a Sufi master and how his death was memorialized in Urdu and Persian poetry.

This chapter focuses on Ozon, the largest disco on Batam, and what it can reveal about processes that shape the lives of Indonesian migrants and, more generally, a particular form of transnational economy. In Ozon women consume Ecstasy in order to deal with feelings of malu—particularly in relation to Islamic prohibitions and the fear that family members will find out they work as prostitutes—and thus more easily engage in prostitution with Singaporean clients. Outside of Ozon relationships with boyfriends, children, and other family members are transformed, as women become the main breadwinners and men are increasingly marginalized. Through this process both female prostitutes and their male Indonesian partners come to recognize themselves as liar, outside the promises of the Indonesian nation and part of the underclass.

In light of his polemical relations with André Breton and his critiques of surrealism, Bataille is widely but mistakenly thought to have an aversion to the dream and the unconscious. Revealing important connections between psychoanalysis and Bataille, this essay seeks to correct this misreading of Bataille, demonstrating that for Bataille, dream and the powers of the unconscious are in fact intimately related to his conception of the sacred. The essay adumbrates a Bataillean “heterological” approach to the dream and dream interpretation, arguing that for Bataille, the dream is a crucial element of ecstatic “nonknowledge” and “inner experience.”

Amy Hollywood discusses the experience of viewing images of torture, mutilation, and devastation. Drawing the distinction between reading descriptions of such horrors and viewing the image, she explores the ways in which Bataille was haunted by photographs of bodily catastrophe. She enforces Bataille’s point that we should look at such photographs if we are, in fact, horrified by them. To become immune to such images, she notes, would render us past the points of ethics and sovereignty.

This chapter locates Herzog’s documentaries vis-à-vis the transatlantic revival of the baroque in twentieth-century culture. It argues that the baroque, which is characterized in aesthetic terms by hyperstylization, offers both an interpretive key to Herzog’s vision of documentary cinema and an important context for his contribution to it. From The Great Ecstasy of Woodcarver Steiner (1974) to Death for Five Voices (1995) to God and the Burdened (2000), Herzog’s documentaries involve various manifestations of the baroque, past and present, sacred and secular, in Europe as well as in Latin America. Understood as a transatlantic topos, the baroque gives new meaning to Herzog’s movement as a traveling director and its relationship to his documentaries in particular.