Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill by Robert Whitaker
This well documented and shocking book gave me a more sobering view of historical and present-day facts about psychiatric treatments, medicines and research.
I don’t think it’s enough to hear broad assertions about these problems. This book brings the facts together so that we can get serious about finding the best treatments and no longer follow the system blindly.
The author covers four periods in the history of psychiatric medicine:
Benjamin Rush arrived at the hospital in Philadelphia. He had two contradictory sides to him. He was a believer in humanitarian reforms generally, and improved the living conditions of the patients. However, he also zealously followed the scientific establishment and the methods advocated by the English mad-doctors.
It’s a relevant point today: he along with other doctors at the time would shut down whatever compassion and moral beliefs they had, in order to follow the so-called “science” and alleged experts. The former should rule over the latter, but we still live in a world where the power-hungry run amok doing what they want with “science” and abolishing respect and compassion (morality).
The treatments of the English mad-doctors: For example, Thomas Willis, 1684, referred to the insane as brutes, and advocated terror and torture to “cure” or “break” the mentally ill, through being beaten, tortured and chained.
The treatments advocated were to physically weaken the mad and get them to think about the pain: bleeding, purges, emetics, nausea-inducing chemicals, near-starvation diets, blistering, spinning chairs, dunking them suddenly in cold water, pummeling them with water under high pressure, near-drowning (like water-boarding). Rush invented a horrible immobilization therapy.
Even King George III was mistreated by the mad-doctors, who took the credit for his recovery and used it for their marketing.
Thankfully, the next phase of treatment (in reaction) is very interesting and hopeful. After about 1813, there was a new type of treatment which became very big called “moral treatment” led by the Quakers were they treated the patients as human beings who should live with dignity.
It actually began in 1793, when Philippe Pinel in France, followed the example of an asylum superintendent and advocated kind treatment towards the insane, which worked very well. Pinel talked to the patients and listened to them.
Pinel argued that this meant the illness wasn’t organic but due to life’s stresses. To me, the important issue is whether treatments are helpful or harmful. A secondary but important issue comes up when reading these accounts about the causes of mental illness. After reading the author’s arguments, it seems to me these causes are still up in the air and not enough is known yet. I would think that a nurturing environment would help a patient’s body and brain heal itself, regardless of the causes.
The York Quakers in England, led by William Tuke went all out to implement moral treatment. Their treatment home was opened in 1796. Lots of fresh air, activities, food, parties, learning.
They followed the philosophy of Aeschylus:
“Soft speech is to distemper’d wrath, medicinal”.
“During the York Retreat’s first fifteen years, 70 percent of the patients who had been ill for less than twelve months recovered…”.
To be continued:
1900-1950: the era dominated by eugenics doctrine, and also brain-damaging therapies.
1950-1990: neuroleptics, propaganda, how they shut down receptors in the brain.
1990s-present: the psychiatric and media story-telling about “atypical anti-psychotics”.