Category Archives: mental illness

Sneers could not win it for Remain

Screen Shot 2016-06-25 at 00.31.48For a long time, writes Dalrymple, Britons who wanted their country to leave the European Union were regarded

almost as mentally ill.

The Leavers

didn’t have an opinion; they had a pathology. Since one doesn’t argue with pathology, it wasn’t necessary for the Remainers to answer the Leavers with more than sneers and derision.

Even after the vote,

the attitude persists. Those who voted Leave are described as small-minded, xenophobic, and fearful of the future. Those who voted Remain are described as open-minded, cosmopolitan, and forward-looking. The BBC suggested as much on its website. The desire to Leave was a return to the insularity that resulted in the apocryphal headline Fog in Channel — Continent cut off.

Screen Shot 2016-06-25 at 09.52.07If insularity is indeed on the rise, it is, Dalrymple notes,

affecting increasing numbers of Europeans.

Before the vote,

the danger of Brexit to the integrity of the EU was described in the French media in pathological terms, as a possible ‘contagion’ rather than an example to be followed or not.

The EU is faced, Dalrymple points out, with a dilemma.

On the one hand, it will not want to make Brexit too painless for Britain, in case other countries follow suit. On the other, it will not want to disturb trade with one of Europe’s largest economies. Britain’s trade with Europe is largely in Europe’s favour; it’s easier for Britain to find alternative sources of imports than for Europe to find alternative export markets.

One reason for the success of the Brexit campaign

was Barack Obama’s intervention, when he threatened that if Britain voted to leave the Union, it would have to go to the ‘back of the queue’ as far as trade agreements were concerned. This sounded like bullying, and was not well-received by much of the British population, which had already been subjected to quite a lot of such bullying from others. If I were an American, I shouldn’t have been pleased with it either, for Obama spoke not as a president with a few months left in office, but as a president-for-life, or at least one with the right to decide his successor’s policy.

Laxative therapy for agitated paranoiacs

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Lomax’s 1921 exposé

For most of their existence, writes Dalrymple, mental hospitals were

custodial rather than therapeutic institutions.

Their methods could be somewhat crude. In The Experiences of An Asylum Doctor, With Suggestions for Asylum and Lunacy Law Reform (1921), Montagu Lomax, a medical officer at Prestwich Asylum,

described how he and his colleagues treated suicidal melancholics and agitated paranoiacs. They sat the melancholics against a wall, placing a bench in front of them to prevent them from moving, while an attendant watched them to ensure that they did not do away with themselves.

Screen Shot 2016-05-12 at 07.49.48Croton oil, a very powerful laxative,

subdued the agitation of the paranoiacs, who became so preoccupied with the movement of their bowels that they had no time or energy left to act upon the content of their delusions.

A leading theory, Dalrymple notes, was that of focal sepsis.

One of the asylums of my city had the best-equipped operating theatre of its time, where an enthusiastic psychiatrist partially eviscerated his patients and removed all their teeth, on the theory that madness was caused by a chronic but undetected and subclinical infection in the organs that he removed.

Screen Shot 2016-05-12 at 08.31.18Later, a visiting neurosurgeon

used the theatre to perform lobotomies on patients who were scarcely aware of what was being done to them.

Doctors also tried

more ‘advanced’ treatments, such as insulin coma therapy, in which they gave schizophrenic patients insulin to lower their blood sugars to the point at which they became unconscious, sometimes with fatal effect.

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Companion volume to the Lomax work

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Prestwich Asylum

Prestwich Asylum

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A leading proponent of focal sepsis theory was Henry Cotton of the New Jersey State Hospital for the Insane, Trenton

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Patients became so busy with their bowels, they had no time to act on their delusions

Bureaucratic mentality

H.M. Prison Winson Green, where Dalrymple was a specialist

H.M. Prison Birmingham

Speaking grosso modo, Dalrymple writes that prison officers he worked with were more astute and kinder than staff at psychiatric hospitals.

They had not had their heads filled with psychological jargon. When they came to me to tell me that a prisoner was not himself, or was acting strangely, or that ‘he’s not your typical con’, I soon learnt to take their observations seriously.

Rampton Secure Hospital

Rampton Secure Hospital

Dalrymple says that prisoners he knew were in general

far more afraid of psychiatric hospitals than they were of prisons. One of their most plaintive cries was, ‘You’re not nutting me off, are you, doctor?’

In official reports of disastrous cases in psychiatric hospitals, salient phrases include ‘lessons have been learnt’ and ‘errors of communication’.

One could write almost all reports on disastrous cases before they have occurred. By ‘lessons have been learnt’ is meant ‘it will be exactly the same next time’.

The lesson that has been learnt

is always that a new form, longer and more complex than the old, should be introduced. The form-filling gets in the way of genuine contact with or concern for the patient. The form-filling is the work itself.

Mental mastery

Drawing by Hyacinth Freiherr von Wieser at the Prinzhorn Collection, 'the first, largest, and best collection of art by psychotic patients'. Dalrymple goes on: 'To Dr Hans Prinzhorn [1886-1933] belongs the honour, to my mind a considerable one, of having recognized artistic merit in the productions of psychotic persons and not merely pathological manifestations of grossly disordered psyches. It bespeaks a laudable openness and largeness of spirit in him as well as an admirably independent aesthetic judgment.'

Drawing by Hyacinth Freiherr von Wieser. Held at the Prinzhorn Collection, ‘the first, largest, and best collection of art by psychotic patients’, says Dalrymple. ‘To Dr Hans Prinzhorn [1886-1933] belongs the honour, to my mind a considerable one, of having recognized artistic merit in the productions of psychotic persons and not merely pathological manifestations of grossly disordered psyches. It bespeaks a laudable openness and largeness of spirit in him as well as an admirably independent aesthetic judgment.’

The lie that mental illness is no different from any other

Many people persist in it, Dalrymple writes.

All-pervasive lunacy

Screen Shot 2013-04-05 at 01.44.48Dalrymple says he doubts, after publication next month of the fifth edition of the APA’s Diagnostic and Statistical Manual, that it will be possible any longer to find anyone, anywhere, who is not suffering from some form of mental illness.