Category Archives: psychiatrists

Psychoanalysis is that mental illness for which it regards itself as therapy

An American psychologist by the name of John Gartner argues that Donald Trump should be removed from office on psychiatric grounds:

We live in a pre-fascist society…The German psychiatric association said nothing during the rise of Hitler…We are facing a crisis that threatens to engulf the world in flames…Trump meets standards for commitment and should be required to undergo psychiatric evaluation, whether he wants to or not…The man is threatening to murder an entire country…We cannot call the authorities because the homicidal patient is the authorities.

Dalrymple notes that Gartner

displays no knowledge of or imaginative insight into what it is like to live in a totalitarian dictatorship—his Jewishness notwithstanding—despite countless memoirs, academic books, and films attesting to and describing life under authoritarian rule. Such ignorance or lack of imagination is culpable. For an American to compare contemporary life in the USA, no doubt unsatisfactory as it is in many respects, with life in a fascist dictatorship is self-dramatising, self-pitying, and an insult to those millions who suffered or died under totalitarian dictatorships.

It is legitimate to oppose the government and to despise the person of the president;

it is another thing to claim jurisdiction over whether he should be entitled to be president and whether he ought to be removed by committal to a mental institution. In the Soviet Union, psychiatrists occupied the kind of commissarship that Gartner is appealing for.

Gartner

shows an implicit contempt for US institutions and history if he thinks that the election of one allegedly unstable man can turn his country into a fascist dictatorship almost overnight.

He is

what Kraus said of psychoanalysis, a cause of the disease it pretends to cure. He believes that people who show instability, anger, paranoia, feelings of persecution, and cognitive confusion would and should be involuntarily committed for psychiatric evaluation.

Dalrymple suggests that Gartner read Chekhov’s 1892 short story Ward No. 6, in which Dr Ragin is committed to his own asylum.

A satanic gynæcologist

Dalrymple points out that J.G. Ballard’s High-Rise (1975)

has several doctors as characters: a lecturer in physiology at a medical school, a psychiatrist, some neurosurgeons, and a gynæcologist.

The book

is typical of his dystopian genre. The high-rise of the title is one of four 40-storey blocks of flats built in the docklands area of London (as the novel was published in 1975, the location is an instance of Ballard’s prescience).

The residents of the new development, all of the professional classes,

start a war against each other of a class nature (the higher the floor you live on, the higher your social status).

Eventually there is anarchy.

Everything is vandalised, the services cease to work, rubbish accumulates everywhere, the walls are covered in graffiti, and the residents raid one another for food and eat each other’s pet dogs.

Dalrymple notes that almost every element of Ballard’s fictional horror is visible in less extreme form in the real world today.

Pangbourne, the gynæcologist,

is among the worst characters in the breakdown of order. Rich and successful, he lives on the highest floor, the 40th, and has led a raid with women acolytes to the lower floors, capturing an accountant and a meteorologist.

Dalrymple asks:

Which of us has never met a Pangbourne?

27 idiotic mental health ‘experts’

Dalrymple writes that The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President (2017) is

principally an echo chamber for the thoughts and feelings of those who abominate Mr Trump.

The authors relay their political preferences rather than provide any independent or dispassionate knowledge.

Dalrymple’s chief objection to the book

is not so much its transgression of a rule of professional ethics, but its profound, though predictable, banality.

Psychological ‘diagnosis’ of this kind

amounts to little more than re-description of easily and publicly observable traits and conduct. Anyone reading the 360 pages of this book will probably come away with nothing new to him, no fact that he did not know before, and no opinion that he had not heard before.

The explanatory value of the diagnoses offered by the ‘experts’ is

virtually nil.

For example,

we know that Mr Trump has narcissistic personality disorder because he is narcissistic; he is narcissistic because he has narcissistic personality disorder. This is the kind of ‘explanation’ that Molière ridiculed: opium produces sleep because it has within it a dormitive property.

Trump, the book informs us,

lacks self-esteem. That is why he is so narcissistic. He is always trying desperately to compensate for his permanently damaged self-conception.

Of course, says Dalrymple,

if he were a morbidly shy and retiring man, the same lack of self-esteem would explain it. In effect, then, the same factor explains everything from the grossest exhibitionism to the most profound social withdrawal.

Jargon that passes for science

Dalrymple writes that he has given evidence in cases

in which various psychiatrists have sought to explain (or is it excuse?) murderers because of their difficult childhoods, poor upbringing, bad education, and so forth.

He has watched

relatives of victims foully done to death squirm with pain and disgust as feeble exculpations of the culprits are offered in the language not so much of science as of jargon.

The Cheshire cat

The psychiatrist and communist fellow-traveller Reg Ellery, writes Dalrymple,

was of a type by no means uncommon, the intellectual who changes his mind but whose certainty is like the grin of the Cheshire cat, being what remains when everything else has disappeared.

Dalrymple adds:

I, of course, am not at all like that; at least, I don’t think that I am. No, no, I am quite certain that I am not.

Sincere, modest Stalin versus the Nazi sodomites

Dalrymple leafs through Eyes Left! (1943) by Reg Ellery, the Australian psychiatrist and fellow traveller, and is amused by this sort of stuff:

The Soviet Union must be the pattern for our reconstructional efforts. We should remember that it succeeded in spite of overwhelming obstacles because the socialist ideology appealed to men and women with courage and enthusiasm, willing to risk personal pleasure and private satisfaction for the splendid purpose in the task that lay ahead of them. We, likewise, can succeed if we can enlist the pliant sympathies of youth to a doctrine which aims at the abolition of the exploitation of man by man.

As for Stalin, Ellery found him to be

a man whose modesty is as disarming as his determination is inflexible—a man of great vision, a sincere student, a warm friend.

Dalrymple explains also that Ellery felt that he had discovered the secret source of German fascism, which he identified as homosexuality. He appeared to blame the whole of Nazism on homosexuality, latent or otherwise. Ellery wrote:

Nazism is a homosexual culture. The Nazi ideal is masculinity. The typical Nazi has the homosexual’s fear of the female. Hitler and his satellites, under the strong pressure of their own latent homosexuality, have foisted this masculinity on the German nation once again, knowing, perhaps, that militarism flourishes best in the atmosphere of repressed homosexuality.

Don’t mention the Muslims!

screen-shot-2016-12-18-at-10-02-55The religion we dare not name

Lying in bed late one night unable to sleep, Dalrymple resorts to a normally reliable curative: the British Journal of Psychiatry.

Two papers in particular quickly banish the insomnia,

  • one by Jeremy W. Coid, Kamaldeep Bhui, Deirdre MacManus, Constantinos Kallis, Paul Bebbington and Simone Ullrich headed Extremism, religion and psychiatric morbidity in a population-based sample of young men,
  • and one by Kamaldeep Bhui, Maria João Silva, Raluca A. Topciu and Edgar Jones on Pathways to sympathies for violent protest and terrorism.
Bognor Regis Chess Club in the great days

Bognor Regis Chess Club in the great days

Dalrymple writes that in addition to being quite unilluminating, the articles’ conclusions are

as dull as the annual accounts of a local chess club.

The authors

would make Armageddon sound boring.

They are also pusillanimous. We all know, Dalrymple notes,

what kind of terrorism and extremism the authors are thinking of, but the title of neither paper mentions it. We walk permanently on eggshells.

screen-shot-2016-12-18-at-10-33-38What religion are we talking about? The articles do not tell us. The whole subject

is dealt with in so opaque a fashion that it is difficult not to believe that the authors feared retribution—from the politically correct if not from terrorists themselves. They are like those puppies that, being curious, approach a danger, but then retreat, approach again, and retreat again.

Perhaps the authors wished to prevent readers from drawing the obvious conclusion, that

Enoch Powell had been right all along.

screen-shot-2016-12-18-at-10-36-55We should all like to know, says Dalrymple,

why some people become terrorists, other than for the most obvious reason: that to kill, maim, and destroy, supposedly for a good cause or some allegedly higher purpose, is a delight to a certain kind of person, worth even dying for. In addition, I doubt that there are many more self-important people than terrorists.

screen-shot-2016-12-18-at-10-46-45You might think that psychiatry and psychiatrists would be able to shed some light on the matter, but this, Dalrymple points out,

is a manifestation of a modern superstition, that human self-understanding has made great strides pari passu with technical advances such as brain scans and a knowledge of neurochemistry. In fact, we have not advanced beyond Pope’s description of Man as ‘the glory, jest and riddle of the world’.

screen-shot-2016-12-18-at-10-49-03screen-shot-2016-12-18-at-10-50-26

 

 

Placebo effect on the doctor

Screen Shot 2016-09-01 at 08.39.32Dalrymple relates that in Augy Hayter’s Fit to Be Tied,

a patient who has escaped from an asylum returns to his former office, where he was the boss, and advertises for an employee. A young man applies, but in the middle of his interview a doctor (described as having ‘the arrogance of insecurity’) and a nurse arrive to haul him back to the asylum.

The nurse returns

to the office to reassure the applicant, who asks, ‘Is it true he is being given shock treatment?’ The nurse replies that it is and it isn’t; he goes through the motions of having it, but the apparatus has been disabled so that no electricity goes through his brain. The doctor does not know this but is satisfied with the result.

The play, says Dalrymple,

seems to have been inspired by the commonly repeated story of the electroconvulsive therapy clinic in which the machine had broken down but nobody noticed: to which one can only say they cannot have been very observant.

Smack from the shrink

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Anna Kavan

The novelist Anna Kavan, writes Dalrymple,

was for many years dependent on Karl Theodor Bluth, a psychiatrist who had been an exile from Nazi Germany and came to live in England. She found in him a soul mate, and it was he who supplied her, legally, with her heroin, sometimes injecting her with it. Bluth was himself a writer, having published essays in Cyril Connolly’s Horizon and a book on the philosophy of Leibnitz.

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Anna Kavan, Portrait of Dr Karl Theodor Bluth, gouache on paper, c.1963

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Colectomy will make you sane

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Henry Cotton

How do we know doctors aren’t in the grip of collective delusions?

Dalrymple notes that an untreated psychotic’s situation can be desperate, but points to the danger of professional abuse once authority is handed over to alleged experts.

He reminds us that among the treatments developed by psychiatrists are

  • frontal leucotomy: nerve pathways in brain lobes are severed from those in other regions
  • Metrazol-induced convulsion therapy: shocks are administered, giving rise to convulsions
  • insulin coma therapy (Insulinschockbehandlung): the patient is turned hypoglycemic with repeated injected insulin
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NJ State Hospital for the Insane, Trenton (John Notman, 1848)

Reviewing Andrew Scull’s Madhouse: A Tragic Tale of Megalomania and Modern Medicine (2005), Dalrymple looks at the case of Henry Cotton, head of the New Jersey State Hospital for the Insane at Trenton.

Cotton believed that madness was caused by focal sepsis — subclinical infection of the teeth, tonsils, sinuses and colon. The answer

was to remove the teeth and tonsils, wash out the sinuses, and cut out the colon. The latter operation, performed in the asylum by Cotton himself — though he had no formal training in surgery — had a death rate of up to 33 per cent.

The operation was a success but the patient died

Phyllis Greenacre with Curt Richter

Phyllis Greenacre with Curt Richter

Cotton was undeterred.

He claimed a very high success rate for his operations, many of which were forced upon unwilling patients: 85% of his lunatics were cured by them, he said. A self-promoter and publicist, he was lionised, especially in Britain.

His claims were disputed,

particularly by Phyllis Greenacre, who proved that the chief clinical effect of his operations was death.

But Cotton

was protected by his mentor at Johns Hopkins, Adolf Meyer, an intimidating pedant rather than a real scientist who was the doyen of US psychiatry for many decades. He wanted to avert a scandal that would damage the standing and power of the profession, and was prepared to countenance the continued mutilation of patients by Cotton to do so.

Adolf Meyer

Adolf Meyer

Meyer suppressed Greenacre’s work and was to write

a laudatory obituary of Cotton, though he must have known by then that Cotton was responsible for hundreds of deaths and untold misery.

How, asks Dalrymple, did so flimsy and, to our eyes, foolish a theory of the cause of madness come to be accepted? Dalrymple points out that

  • the germ theory of disease, which elucidated so many mysteries, was comparatively new
  • the syphilitic cause of general paralysis (from which up to a fifth of the asylum population suffered) had just been discovered
  • hidden infections do often result in acute confusion in the elderly, including hallucinations

It was a short step to hypothesise an infective cause for all madness.

Screen Shot 2016-04-03 at 13.56.25Cotton

believed in his theory to such an extent that, as a prophylactic, he extracted the teeth of two of his sons and subjected one of them to a colectomy. (Both committed suicide as adults.) Later he had his own teeth extracted, believing focal sepsis to be the cause of his angina.

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