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A 20-Year-Old Gouged Out Her Own Eyes. Here’s What Makes People Do This.

Last month, Kaylee Muthart blinded herself. While shocking, this is not the first time someone has removed their own eyes. We spoke to an expert about the history of eye-gouging and why it happens.

Posted on March 14, 2018, at 8:48 a.m. ET

Kaylee Muthart, a 20-year-old from South Carolina, made headlines in February when she gouged out both of her eyes while high on methamphetamine. She recently told her story for the first time to Cosmopolitan.

In the as-told-to article, Muthart describes how she went from a straight A student at her high school in Anderson, South Carolina, to a dropout who regularly used alcohol and marijuana. After losing her job and boyfriend, Muthart (who says she was later diagnosed with bipolar disorder after the incident), began taking ecstasy and smoking methamphetamine to cope. Muthart described herself as a "religious Christian" and she would read the Bible while high. "I convinced myself that meth would bring me even closer to God," she told Cosmopolitan. Despite multiple attempts to stop using, Muthart became addicted to snorting and injecting meth.Concerned about her daughter's mental health and drug use, Muthart's mother encouraged her to enter rehab or a psychiatric treatment facility. Her mother recorded a conversation during which her daughter said she didn't "want to be in this world." Her mom hoped to use the recording to obtain a court order to commit Muthart to a facility. The next day, Muthart bought more drugs and that night she used more than she had ever used before.
Kaylee Muthart / Via facebook.com

In the as-told-to article, Muthart describes how she went from a straight A student at her high school in Anderson, South Carolina, to a dropout who regularly used alcohol and marijuana.

After losing her job and boyfriend, Muthart (who says she was later diagnosed with bipolar disorder after the incident), began taking ecstasy and smoking methamphetamine to cope. Muthart described herself as a "religious Christian" and she would read the Bible while high. "I convinced myself that meth would bring me even closer to God," she told Cosmopolitan. Despite multiple attempts to stop using, Muthart became addicted to snorting and injecting meth.

Concerned about her daughter's mental health and drug use, Muthart's mother encouraged her to enter rehab or a psychiatric treatment facility. Her mother recorded a conversation during which her daughter said she didn't "want to be in this world." Her mom hoped to use the recording to obtain a court order to commit Muthart to a facility. The next day, Muthart bought more drugs and that night she used more than she had ever used before.

After injecting a large dose of methamphetamine, Muthart started hallucinating and believed she had to sacrifice her eyes in order to save the world. So she did.

Muthart was high and wandering along a railroad track on her way to her church when she thought God was asking her to make a sacrifice. Numb to pain from the drugs, she gouged out her eyes, and it took several men to subdue her before paramedics arrived and sedated her.

After Muthart was taken to a nearby hospital and treated for her injuries, she was transferred to a psychiatric facility. It was there where she was finally diagnosed with bipolar disorder and prescribed antipsychotic medication.

This is not the first time in history this has happened. Also called "self-enucleation," this is a rare form of self-inflicted injury usually associated with psychosis.

It may sound like something out of a horror movie, but self-enucleation (or autoenucleation) is a very real and unfortunate psychiatric emergency. It's rare, and in the past 50 years, there have been over 50 documented cases of complete or partial self-enucleation in English medical journals, according to a 2012 study published in the British Journal of Ophthalmology. What would drive someone to commit such a violent act of self-harm? Psychosis, or the loss of touch with reality. "All of these patients have had a psychotic episode and developed delusions about their eyes," Matthew Large, coauthor of the study and conjoint professor of psychiatry at the University of New South Wales in Sydney, told BuzzFeed News. Just last December, a Colorado prisoner grew out his fingernails and removed his eyes after guards allegedly ignored his psychotic episodes, the Guardian reported. The symptoms of psychosis include hallucinations, or hearing things that are not present; delusions, or strongly-held false beliefs; and cognitive impairment, or the inability to think logically. "People who remove their eyes due to psychosis often believe that they can see evil or they are casting evil," Large said. Similar to Muthart, many patients believe their eyes pose a threat to their loved ones.
Georg Bartisch / Wellcome Library, London / Via wellcomeimages.org

It may sound like something out of a horror movie, but self-enucleation (or autoenucleation) is a very real and unfortunate psychiatric emergency. It's rare, and in the past 50 years, there have been over 50 documented cases of complete or partial self-enucleation in English medical journals, according to a 2012 study published in the British Journal of Ophthalmology.

What would drive someone to commit such a violent act of self-harm? Psychosis, or the loss of touch with reality. "All of these patients have had a psychotic episode and developed delusions about their eyes," Matthew Large, coauthor of the study and conjoint professor of psychiatry at the University of New South Wales in Sydney, told BuzzFeed News. Just last December, a Colorado prisoner grew out his fingernails and removed his eyes after guards allegedly ignored his psychotic episodes, the Guardian reported.

The symptoms of psychosis include hallucinations, or hearing things that are not present; delusions, or strongly-held false beliefs; and cognitive impairment, or the inability to think logically. "People who remove their eyes due to psychosis often believe that they can see evil or they are casting evil," Large said. Similar to Muthart, many patients believe their eyes pose a threat to their loved ones.

Kokular, Aleksander, National Museum of Warsaw / Via cyfrowe.mnw.art.pl

Historically, psychiatrists thought self-enucleation was a form of self-inflicted punishment resulting from sexual or Christian religious guilt. The act is described in a well-known passage from the Gospel of Matthew: "And if thy right eye offend thee, pluck it out, and cast it from thee." But arguably the most famous account of self-enucleation is from Sophocles' epic tragedy, Oedipus Rex. The protagonist, Oedipus, gouges his own eyes out after realizing he slept with his mother and killed his father.

The belief that people injure their eyes due to psychosexual guilt was prolonged by Sigmund Freud's "Oedipus complex," first proposed in the early 1900s, Large said, and became a central myth surrounding self-enucleation. "We now know it has very little to do with religion or sexual guilt and there is no deep psychological insight, it's due to psychosis," Large said.

Psychosis can result from an untreated psychiatric disorder, such as schizophrenia or drug use. About 40% of methamphetamine users experience psychotic symptoms while high.

The common psychiatric illnesses that cause psychosis are untreated schizophrenia, psychotic depression, psychotic mania, and bipolar disorder, Large said. "Many of these patients have never-treated schizophrenia, which means they might not even know until they have their first episode of psychosis and remove their eyes," Large said. Psychosis is also caused by certain medications and drugs, Large said, and methamphetamine is a particularly common culprit. "It is thought that one of the causes of psychosis is too much dopamine, and meth causes a massive release of dopamine in the brain," Large said. While this excess of dopamine (pictured above) can cause a temporary state of euphoria, it can also impair decision-making and cause deluded thinking. In some of these patients, repeated use of methamphetamine actually induces a psychotic disorder, so the psychotic symptoms like delusions occur after intoxication or withdrawal from the drug. Of those who experience methamphetamine psychosis, Large said, about half will develop schizophrenia over time.In Muthart's case, her untreated bipolar disorder made her more prone to using drugs like crystal meth and more prone to experiencing psychotic symptoms while high.
Visuals Unlimited, Inc. / Getty Images / Via gettyimages.com

The common psychiatric illnesses that cause psychosis are untreated schizophrenia, psychotic depression, psychotic mania, and bipolar disorder, Large said. "Many of these patients have never-treated schizophrenia, which means they might not even know until they have their first episode of psychosis and remove their eyes," Large said.

Psychosis is also caused by certain medications and drugs, Large said, and methamphetamine is a particularly common culprit. "It is thought that one of the causes of psychosis is too much dopamine, and meth causes a massive release of dopamine in the brain," Large said. While this excess of dopamine (pictured above) can cause a temporary state of euphoria, it can also impair decision-making and cause deluded thinking.

In some of these patients, repeated use of methamphetamine actually induces a psychotic disorder, so the psychotic symptoms like delusions occur after intoxication or withdrawal from the drug. Of those who experience methamphetamine psychosis, Large said, about half will develop schizophrenia over time.

In Muthart's case, her untreated bipolar disorder made her more prone to using drugs like crystal meth and more prone to experiencing psychotic symptoms while high.

The only way to prevent this kind of self-harm is by understanding psychosis, and treating the underlying cause as soon as possible.

"People do react very strongly to [self-enucleation] and it doesn't necessarily help the patients. They are very sick people in need of a lot of care, treatment, and rehab," Large said. It's important to treat the underlying psychiatric illness or drug addiction before the delusions about one's eyes become strong enough to prompt someone to hurt themselves.Not to mention, attempting to blind yourself can be fatal. "Some of these patients just die because they end up pulling off an artery and it causes a hemorrhage in the brain," Large said."The eyes are the only part of the body that hasn't been ritually mutilated by one culture of another, because we have developed very strong prohibitions and mechanisms of protecting our eyes — these can only be overcome by very severe mental illness," Large said. "Self-enucleation is a clear example that delusions are firmly held real beliefs and they can be very strong. [...] Psychiatric problems are not made up."
Jenny Chang / Via buzzfeed.com

"People do react very strongly to [self-enucleation] and it doesn't necessarily help the patients. They are very sick people in need of a lot of care, treatment, and rehab," Large said. It's important to treat the underlying psychiatric illness or drug addiction before the delusions about one's eyes become strong enough to prompt someone to hurt themselves.

Not to mention, attempting to blind yourself can be fatal. "Some of these patients just die because they end up pulling off an artery and it causes a hemorrhage in the brain," Large said.

"The eyes are the only part of the body that hasn't been ritually mutilated by one culture of another, because we have developed very strong prohibitions and mechanisms of protecting our eyes — these can only be overcome by very severe mental illness," Large said. "Self-enucleation is a clear example that delusions are firmly held real beliefs and they can be very strong. [...] Psychiatric problems are not made up."

Muthart, now blind, has returned home and is currently adjusting to her new life.

Once she has completed her outpatient psychiatric treatment, 90 days of Narcotics Anonymous, and physical therapy, Muthart hopes to return to school and fulfill her dreams of becoming a marine biologist. Although it's been difficult after losing her eyesight, she is staying optimistic.

"It took losing my sight to get me back on the right path, but from the bottom of my heart, I'm so glad I'm here," Muthart said.

If you or someone you know is struggling with drug abuse or addiction, here are please call the Substance Abuse and Mental Health Services Administration treatment referral hotline (1-800-662-4357) for 24-hour assistance or visit Findtreatment.samhsa.gov. You can also visit the American Addiction Centers website or call 888-987-9927 for more resources and support.

In the case of a medical or psychiatric emergency, call 911.

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