Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally III

By Richman, Sheldon | Ideas on Liberty, May 2003 | Go to article overview

Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally III


Richman, Sheldon, Ideas on Liberty


by Robert Whitaker

Perseus Publishing [bullet] 2002 [bullet] 352 pages [bullet] $27.00 hardcover; $17.50 paperback

Any snapshot can be misleading because it is necessarily out of context. Similarly, the flattering self-descriptions from the various headquarters of the mental-health industry can mislead anyone who is unfamiliar with the history of psychiatry. The superficial observer may be forgiven for believing that the industry is dedicated to healing.

That impression, however, is easily overcome with some historical knowledge, and medical journalist Robert Whitaker's Mad in America, though hardly the first in this genre, lends a helping hand in that regard.

As Whitaker demonstrates, the history of psychiatry is a story not of diagnosis and treatment, but of the brutal control and torture of undesirables-called madmen or the insane or schizophrenics-by doctors deputized by the state. From the start, psychiatry treated its captives like beasts and laboratory rats.

The descriptions of "treatments"-which in most cases were not seen as such by those who inflicted them, but rather as methods of restraint and punishment-might make readers queasy. For example: "The Bath of Surprise became a staple of many asylums [in the early nineteenth century]: The lunatic, often while being led blindfolded across the room, would suddenly be dropped through a trapdoor into a tub of cold water-the unexpected plunge hopefully inducing such terror that the patient's senses might be dramatically restored." As this example indicates, a medical rationalization always accompanied the abuse.

If one thinks times have changed, Whitaker catalogs its successors up to the present, including insulin coma therapy, electroshock, lobotomy, and drugs that induce the symptoms of Parkinson's disease. It reads like a description of a chamber of horrors. Nevertheless, each new "therapy" was hailed as a beneficent medical breakthrough that would return the insane to normal life. The inventor of lobotomy, Egas Moniz of Portugal, won the Nobel Prize for medicine in 1949. But invariably the optimism fizzled, a new therapy came along, and the old one was abandoned and even condemned. The pattern continues to this day.

Two points need to be stressed: (1) Doctors were not candid with their patients or the public about the risks and pain associated with these procedures, and (2) the patient's objections were irrelevant. For instance, "|T]he prevailing opinion among America's leading electroshock doctors in the 1940s and 1950s was that in the confines of mental hospitals, they had the right to administer such treatments without the patient's consent, or even over the patient's screaming protests," Whitaker writes. …

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