November 22, 2010

A Not-So-Happy History Lesson

This particular post has not been a “fun” one for me to write.

But it's important. It's vital. It's noteworthy. It's relevant.

And it's advisory, to all of us.

I've been doing some research, on my own, on the history of mental illness- what its path has looked like as its been tunneling through time. And, after realizing the true, tragic qualities of its past, I decided to make a blog post revolving around some of my findings, in the form of a historical piece. It's not pretty, and it's certainly not nice. So, perhaps young children should stop reading at this point.

I wrote this in an attempt to inform others out there (you) of the reality that has faced us over all of the years before now, to lend flesh to the history behind the reality facing us today. Hopefully, you'll be appalled, or simply react, enough to tell a friend, or share the link, or conduct your own research, or just do something to bring awareness to this issue, to help mend that which has been so badly broken over all these thousands of years, to try and heal those who are breaking, who are being broken, now.

This isn't the whole picture, by any stretch of the imagination. But it's a pertinent part of it— of our picture (yours and mine). I just hope this makes an impact of some kind on your thoughts about the matter. And if you have questions, maybe about my sources (or anything else), just email me and I will gladly answer. Or, better yet, if you have doubts, then do your own delving. If you don’t believe a figure, date, name, or detail that I mention, then a mere matter of minutes with Google will settle all of your queries, and probably many more, besides.

It's important, and vitally so, when considering how to deal with mental illness today, to be aware of how it has been "dealt with" in our forefathers' yesterdays...

A History of America's (Mental) Illness
(And How She Turned Away)

The history of mental illness, and the attempted “treatments” for it, across the entire world, is a brutal and ignorant one. Up until the late 18th century, mental illnesses were thought to be the products of sorcery, witchcraft, demonic possession, or other supernatural explanations. Moreover, those with mental illnesses were typically subjected to a broad variety of cruel efforts: absurd and radical rituals, severe abuse and torture (in efforts to “cleanse” their "unholy” bodies), condemnation by their communities as “cursed by the gods,” being forced to consume enormous amounts of dangerous (as well as hallucinogenic, and, sometimes, lethal) drugs and herbs, being put to death, or being cast out completely from their respective societies, ostracized— shunned to walk, live, and, eventually, die alone— all for being too different or strange.

Even when it comes solely to America, the tale of mental illness, and those who have suffered, is a tragedy. The Colonial American society labeled those suffering from mental illnesses, of any kind, as "lunatics," a word that was derived from "luna," the Latin word for "moon." Due to "astrological reasoning," it was a widely-held belief that "insanity" came into a person if a full moon had been present at their birth, or if they had slept under its light for a full night as an infant. The American people declared that these individuals were possessed by the devil, and they were generally removed from society and locked away in prisons. As long as the troubled and unsettling "lunatics" were out of their streets, the colonists did not care, in the least, about where they went, or what happened to them.

The tremendous ignorance and indifference on the part of the American people continued throughout the years, and nearly everyone of the time did nothing but harm to those who were already suffering. Among the myriad of failed attempts at "treatment" were ritual ceremonies (exorcisms), bleeding (typically resulting in either death or the need for lifelong care), invasive and unnecessary surgeries (normally resulting in either death, unnecessary trauma, or severe and permanent disability), induced vomiting, forcibly submerging individuals in ice baths until they lost consciousness, massive shocks of crude electrical current to the brain, imprisonment, or, in some cases, execution. It wasn’t until after the Civil War, with many of the soldiers coping with post-war trauma, that America paid any attention to the topic of mental illness.

That isn't to say that things actually improved after that, though. Even well into the 20th century, things were beyond grim, on the American scene, particularly, for those years also brought a procedure called the "trans-orbital lobotomy." The first time it was ever conducted on a live patient was in 1946, by Walter Freeman, an American "doctor," who developed it for its ease, brevity, and lower level of after-care, much to the satisfaction of his medical peers and the public community at large.

Here is a copy of the instructions for this "medical procedure:"

  1. To induce sedation, inflict two quick shocks to the head.
  2. Roll back one of the patients’ eyelids.
  3. Insert a device, 2/3 the size of a pencil, through the upper eyelid into the patients’ head.
  4. Guided by the markings indicating depth, tap the device with a hammer into the patients’ head/ frontal lobe.
  5. After the appropriate depth is achieved, manipulate the device back and forth in a swiping motion within the patient’s head.

In the late 1940s and early 1950s, Freeman would come to have his own twisted national campaign, driving cross-country in his "lobotomobile" (as he came to christen his vehicle) and performing the procedure for as many doctors as humanly possible. For his initial lobotomies, Freeman used an actual ice-pick from his kitchen. Sometimes, to demonstrate his "procedure," he would show off by "ice-picking" both eye-sockets of a single patient, simultaneously, using two ice-picks, one in each hand.

Because of the new-found ease of the procedure [and Freeman's personal, perverse drive and dedication to circulating his unique practice], its use and employment spread like a wild forest-fire in the heat of summertime, across the nation. Freeman, alone, performed almost 2,500 lobotomies in 23 different states, and was heralded as "the traveling lobotomist" wherever he went. The lobotomy became a morbidly common procedure in asylums across the United States, in many cases being carried out on patients without, or even against, their assent.

The public lauded Freeman for his invention, watching in approval as they read headlines in their papers, which stated that many patients were finally returning home “safely” to their families. What the papers did not mention, of course, was that most of those returning were also now devoid of personality, coherency, and even any interaction, at all, in many cases. The allure of the procedure was that it was easy, quick, and cheap— individuals without license to perform surgery could, and did, perform it. But it also made “troublesome" patients markedly more compliant, effectively silencing their “abnormal” behaviors, their complaints, and their unsettling speech. Were patients returning home? Yes. But only because they were no longer a danger or risk to themselves and others— since they were no longer much of anything at all— not because they were actually cured, or even better.

Eventually, though, because of the vast number of complications and deaths that resulted from the procedure, people familiar with its practice came to refer to it as "psychic mercy killing" and "euthanasia of the mind."

[Ironically enough, the USSR officially banned the lobotomy, early on, in the year 1950, because doctors in the Soviet Union declared it as "contrary to the principles of humanity." They stated that it transformed "an insane person into an idiot." But America did nothing until the late 1970s, when Congress finally decided to investigate the lobotomy, as well as other forms of psycho-surgery.]

Indeed, due to the trans-orbital lobotomy (and other similar procedures), along with the cruelty of crude shock therapy, countless other forms of abuse and neglect, as well as overcrowding, the early/mid-1900s are considered, by many, to be the darkest days for mental health treatment.

[On an interesting side-note, you know what happened to Walter Freeman? While performing his macabre procedure on some poor patient, he backed up to pose for a photograph and bumped into the instrument he was using, still protruding from above the patient's eye-socket, and killed the patient. For that, his medical license was revoked. He spent the remainder of his life driving his “lobotomobile” around the country, until his death from cancer in 1972.]

But, thankfully, things improved from those depths and dirges.

In 1954, the revolution of psychotropic medication began, as "Thorazine" (a powerful anti-psychotic) was introduced into the mental health system. After that, more and more medications began emerging, left and right, leading to the gradual discontinuation of more barbaric and inhumane procedures. Also, in the 1960s, new U.S. government policies concerning mental health were enacted as the centerpieces for John F. Kennedy’s congressional program (mostly in regards to insurance coverage), and those helped the mental illness community as well. As more people began to glimpse a clearer picture of mental illness’ history, and the legitimacy, as well as severity, of the issue, circumstances eventually started to become more accommodating.

Even now, though, even today, we're not there yet. People faced with mental illness are still ashamed of it— ashamed of themselves, ashamed of their family or friends, ashamed of their thoughts and struggles, too embarrassed and fearful to seek out the treatment required. And “mental illness,” itself, is no less a threat than it was in the days of old. As a matter of fact, it seems that we are just now becoming aware of the breadth of its scope. We may have reached a point (finally) where mentally ill people are treated with a measure more of dignity and respect, but that old fear and alienation are still there, prowling alongside the blood.

What we all need to realize is that the true “monster” here is not the person who is suffering. Nor will you find the monster in the faces and actions of our history, even if it is a history that has treated the sufferers monstrously. The monster is not a human being, it is not an institution, and it is not the mistakes of our heritages, histories, and houses.

The monster is the disease.

If you ask me, I think it’s about time we all realize that we’re on the same side…

This post, this account, is near its close, but this tragedy, this story, is far from over.

History has a funny way of catching up to the present (in that it always has, and forever will). But the rest of history (of what will one day be history) is up to us— it’s up to you, it’s up to me, it’s up to our neighbors, our families, our friends, our co-workers, even the complete strangers we pass every day on the streets. It’s up to the kids in our classrooms as much as (if not more than) the politicians in our offices.

Even if we are not dubbed “the winners” by history’s backwards glances, even if we’ll never be the ones "writing" it, if neither you nor I will ever have a voice that will sound outside of our respective lifetimes, even if we’re not suit-and-tied lawmakers, legislators, hand-shakers, or powerful CEOs with outstanding offshore bank accounts, or charismatic military leaders, or writers who will be quoted and called the "voices of their time"— the fact remains:

We're the ones who are living it.

This is our Time, our shared sense of existence, our "now," our precedent.

Let's make it one that matters.


Anonymous said...

Woooow, I hate Walter Freeman now.