Looking Back in History: Part 1
One Interpretation of Past Centuries
Peter Breggin, M.D.
What I'm going to do is take you through a history of psychiatry. The history of psychiatry is almost entirely the history of the biological-behaviouristic model. Psychiatry begins in the 17th century in France with the state mental hospital system. Before the state mental hospital system there was virtually no psychiatry.
In the 17th and 18th centuries, we get the beginnings of the Industrial Revolution and large cities. In these cities, there are poor people, helpless people, people without families, evil people and so forth-all kinds of humanity now in a huge disorganized social system with a vast amount of unemployment. This presented a new problem to the authorities. Somehow, the leprosariums had become empty in France. Since there were these vast empty institutions and a vast social problem, it was decided to use these institutions to take care of, to house and perhaps rehabilitate the social dropouts. The laws for these places, which were called "hôpitaux générales," empowered a physician -- they wanted to make it look medical -- to administer a hospital and to bring into the hospital at his will anyone who was destitute, chronically ill, unemployed, insane.
If you go to your state mental hospital today, you find the great grandchild of this system-it's identical. There have been a few more limits placed on the law, but basically we still have physicians able to commit human beings to hospitals in vast numbers under the guise of "rehabilitation," and most of the people in these hospitals are poor. That's their main characteristic -- they're not necessarily crazy. This is called civil commitment. And the reason it developed was because even in the 17th and 18th centuries there were criminal codes which made it difficult to lock up and label a criminal; so instead, a civil code was developed without the usual protections, and this is still true today. You can get a writ of habeus corpus to get somebody out of a mental hospital. The criminal laws are not relevant to this situation.
If you go to a mental hospital, you're taking your life in your hands, even today. If you go even to a "good" mental hospital, you're still taking your life in your hands, maybe even more so because the good ones especially like to drug you and shock you, whereas in a state mental hospital you might possibly be left alone and maybe get better on your own.
This system of mental hospitals was based on the medical model, on involuntary treatment and civil commitment, and it is today the backbone of psychiatry. Psychiatry doesn't get its power and government support from the analyst or the counselor, it gets it from government-empowered involuntary treatments. It's as if General Motors got the government to say that it could make people consumers of cars. Or more directly, it's as if a religion took over the government and said we will define who is good and evil, who should go where, who should stay here, who should lose their citizenship-and we'll do it under special statutes, and we'll all make believe it's science. I do believe that's exactly what has happened and what is going on.
The medical model is the essence of what allows us to treat so-called "mentally ill" people as if they're non-responsible, as if they're not involved in value conflicts, as if the whole issue is respect for society and adjustment, rather than the fundamental Western values such as the right to be free unless you're injuring somebody. You have a right to live your own life unless you're bringing direct harm to another human being and violating criminal codes. I'm not against the criminal system -- I'm against what is a much more abusive system, the civil commitment system.
In the 1930s, the psychiatric system got totally out of hand. The hospitals were getting bigger and bigger-thousands of people were locked up in antiquated facilities. If you take a bunch of poverty-stricken, uneducated, feeling human beings, some of whom are even crazy, many of them just old, and you dump them into dungeons, what do you get? You get the snake pit. You don't get it because the people are crazy; you get it because you've dumped a whole bunch of people who couldn't take care of themselves anyway into horrible conditions and locked up with nothing to do. And then, you beat them and rape them, at will, which until recently was typical of state mental hospitals. It still goes on a great deal.
The snake pit isn't a problem of madness, as my colleagues would have it; it's a problem of psychiatric oppression of people. In the 30s, governments throughout the world were saying: Enough money. We're not going to put in more than fifty cents a day or whatever -- just enough to feed and house somebody. We're not going to pay any more staff salaries. The situation has got to stop.
So what happens? The physical assault on the brain begins in order to control the people in these giant lockups. Before this, the typical treatment in a state mental hospital was starvation-that was the general "therapy," that's what you got. On top of starvation, you were bled, you were put in spinning chairs, you had leeches attached to you. Read something like Kraepelin's One Hundred Years of Psychiatry. Kraepelin's a great psychiatrist, supposedly. He's describing what happened even in the 19th century: bleeding, spinning, purging, forced vomiting, whipping, beating. The "Father of American psychiatry," Benjamin Rush, who also happened to have bled George Washington to death and locked up his own son to die in a state mental hospital, also invented the "tranquilizer chair" which immobilized people for agonizing hours.
So in the 1930s, it was discovered that beatings and whippings and bleedings didn't really do it; they only resulted in a limited amount of conformity. Besides, it looked so bad to the profession.
Don't miss the conclusion of this historical perspective in the next issue.
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Adapted and Reprinted from Phoenix Rising.