Thursday, August 16, 2012

Kindness versus “Hard Science”

In my previous post I cited Peter Breggin’s Toxic Psychiatry as evidence to call modern psychiatric medical science both dictatorial and devastatingly harmful. Robert Whitaker’s very readable 2002 book Mad in America provides a great deal more detail about how the insane have been cared for in US history.

In the eighteenth century, for example, the insane were not considered human; they were wild beasts that had to be tamed. Hence the prison-like atmosphere, restraints and beatings, the blood-letting, the spinning chair, the dunking in water to the point of nearly drowning, and the administration of powerful emetics. These techniques were used repeatedly, day after day, sometimes for months. The aim of the mad-doctors, as psychiatrists were called prior to the late nineteenth century, was to terrorize patients, to break their will and supposedly knock the insanity out of them.

The twentieth century, as I mentioned in last month’s post, had its eugenics episode, and it is chronicled in detail by Whitaker, but the century also gave us shock therapies: insulin-coma, metrazol (camphor), and electro-convulsive. Administered perhaps hundreds of times, the purpose was to induce seizure, to supposedly shock the delusions and hallucinations out of patients. “Brain-damaging therapeutics” (Whitaker, p. 96), as these techniques were called, produced effects similar to brain trauma.

Transorbital lobotomy, performed with ice picks in the 1940s by the flamboyant Walter Freeman,* was called “surgically induced childhood” (p. 122). And because masturbation was still believed to be a cause of insanity, clitoridectomy was performed until 1950 (p. 79). In 1954 the drug era then began with the introduction of Thorazine.

But what happened in the nineteenth century? To be sure, many of the same cruel and inhumane techniques continued to be used. The Quakers, however, had a better idea, one that spawned the “moral treatment” movement in mental health (pp. 30-38). Recognizing that mental illness was not physiological, that it resulted from being overwhelmed by certain life events, they insisted that kindness, attention, listening, and talking were key to helping the mentally ill.

Fed well and allowed to sew, garden, read, write, and play games, the patients in the Pennsylvania Hospital that opened outside of Philadelphia in 1841 enjoyed a “pastoral comfort.” The hospital included a dining room, a greenhouse, a library, and a museum. The patients were encouraged to develop friendships, dress well, and rethink their behavior. They were urged to exercise free will and, not unlike Glasser’s Choice Theory, choose to be sane. Needless to say, they were neither chained nor beaten.

By 1890 all trace of moral treatment of the mentally ill was gone. The explosive growth of state-run, i.e., bureaucratic, hospitals made it impossible to train attendants in the spirit of kindness and empathy. What really killed moral treatment, though, was the ridicule and condescension put forth by medical doctors, especially the neurologists. They all considered themselves to be “men of hard science” and the moral treatment advocates were just old-fashioned, religious “gardeners and farmers” (p. 37). In the name of science straitjackets and cruelty were brought back; kindness and empathy were out.

The short-lived pastoral comfort of moral treatment brings to mind the “one brief shining moment” phrase from the title song in Camelot. Somewhat similar to King Arthur’s humanitarian moment in legendary history, moral treatment was eclipsed. It was stamped out by “hard science.”

Robert Whittaker is an award-winning investigative journalist. Before writing Mad in America, he subscribed to the conventional wisdom that psychiatry, especially the use of modern neuroleptic drugs, was good for the mentally ill. That is, until he stumbled on “symptom-exacerbation” experiments, conducted well into the 1990s, in which psychiatric researchers were giving patients drugs (such as ketamine, chemical cousin of angel dust) in order to worsen their psychotic symptoms. After this discovery, Whitaker in earnest began researching his book.

Psychiatric reviewers of Mad in America, not surprisingly, were unhappy campers. The reviews in fact were so negative that Whitaker’s editor advised him, if he wanted to make a living as a writer, to stay away from the field of psychiatry. He did so for awhile, writing two unrelated books, but psychiatric survivor groups kept contacting him. As a result in 2010 he wrote Anatomy of an Epidemic, the story behind the tripling of mental health disabilities from 1987-2007—this tripling despite increased usage of the alleged miracle drugs.

I have not yet read Whitaker’s latest book, but in a podcast interview about it with Peter Breggin, Whitaker relates three attempts by the psychiatric profession to silence him with ad hominem attacks and character assassinations. Here’s his response to one of the attempts. The profession, he stated in the interview, has succeeded in keeping him out of magazines where he used to write regularly.

This is how privileged “men of hard science” react when their monopoly and livelihood are threatened by facts. Fortunately, Whitaker has had the courage and independence to press on.

Many years ago William Glasser was denied a position at UCLA because he refused to buy into the medical model. In the 1980s Peter Breggin was threatened with having his license revoked because of comments he made on an Oprah Winfrey television show. (He won his case in court.) From outside the psychiatric establishment, Whitaker now joins this admirable pair.

Gentlemen, I raise a glass to you.

*It is worth noting that prior to taking up the ice pick, Freeman analyzed 1400 autopsied brains and found no differences between the normal and the schizophrenic (p. 115).

Postscript. One of the many tragic ironies in the history of science is the story of Ignaz Semmelweis who discovered the significance of and recommended—futilely in his lifetime—the use of antiseptic procedures in childbirth.

Semmelweis died a brutal death in an insane asylum.

Suffering in 1865 either from a breakdown because none of the “men of hard science” would listen to him or from Alzheimer’s disease or from syphilis, he was deceptively lured to a mental hospital. When he tried to leave, he was severely beaten, put in a straitjacket in a dark cell, doused with cold water, and given castor oil. Two weeks later he died . . . of septicemia, or blood poisoning, which he had argued was the cause of childbed fever and that the poisoning could readily have been prevented by washing the hands with chlorine.


John Kenny said...

Good information. Thanks.

John Kenny said...

What do you think of the mental "make up" of the Colorado mass murderer/shooter ? If we did catscans / x-rays etc. would we find anything unusual in his skull ? My guess is "brain structure normal."
Thanks again for the informative blog.

Jerry Kirkpatrick said...

I would be almost certain that the brain is normal. A Google search brings up many links to Holmes and his psychiatrist.