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Psychiatry's Unholy Trinity - Fraud, Fear, and Force: A Personal Account:

(re-published here from a mental health newsletter from the
Mental Patients Association in Vancouver; by Leonard Roy Frank.)

(appeared in "Ideas on Liberty", November 2002)

Leonard Frank has co-founded the Network Against Psychiatric
Assault, based in San Francisco, and has edited The History of Shock
Treatment, and three books of quotations.



"In 1959 a revolution took place in Cuba, the Cold War was in full
throttle, the Eisenhower era was drawing to a close, and I moved to
San Francisco where I would soon find myself in a hellish world of
imprisonment and torture.

Born and raised in Brooklyn 27 years earlier, I had graduated from
the University of Pennsylvania's Wharton School. After a two-year
hitch in the Army, I managed and sold real estate in New York City and
southern Florida for several years. Despite a poor record, I continued
working in real estate in San Francisco.
A few months into my new job, things began to change for me -
more internally, at least at first, than externally. Like so many of my
generation, I was highly conventional in thought and lifestyle, and my
goal in life was material success - I was a 50's yuppie. But I began to
discover a new world within myself, and the mundane world seemed,
comparatively speaking, drab and unfulfilling. I lost interest in my job
and, not surprisingly, soon lost the job itself. Thereafter, I spent long
hours reading and reflecting on nonfiction books that I found in
secondhand bookstores and at the public library.
The book that influenced me most at that time was 'An
Autobiography: The Story of My Experiments with Truth' by Mohandas
K. Gandhi. I adopted for myself his principle of nonviolent resistance,
his interest in religion, and his practice of vegetarianism. In that book
and other writings of his, Gandhi referred to the works that had helped
shape his life. I was soon reading 'The Bhagavad-Gita', the 'New
Testament', Henry David Thoreau's essay on 'Civil Disobedience', Leo
Tolstoy's 'The Kingdom of God Is Within You', and the essays of Ralph
Waldo Emerson. In keeping with the subtitle of Gandhi's
autobiography, I started my own experimenting, and this led to a
complete revaluation of my previously held values. Toward this end I
broadened my reading to include, among many others, the 'Old
Testament', Lao-tzu (Way of Life), William James (Varieties of
Religious Experience), Henri Bergson (Two Sources of Religion and
Morality), Joseph Campbell (Hero with a Thousand Faces), and the
writings of Abraham Lincoln, Carl Jung, Arnold Toynbee, and Abraham
Heschel.

The learning acquired during this exciting, wonder-filled time
advanced my self-awareness and my understanding of the world.
During this transitional period, however, my parents, who lived in
Manhattan and visited me several times in SanFrancisco, became
concerned with the changes they perceived in me. That I was living on
my meager savings and not 'gainfully employed' upset them. Perhaps
more important, my newfound spiritually centered beliefs and
vegetarian practices challenged them in ways they couldn't handle. We
were at loggerheads: if one side was right, the other had to be wrong,
and neither side was willing to compromise.

The situation seemed to call for a parting of the ways, at least for a
time. But my parents weren't willing to back off.
They attributed the rift between us to my having a mental disorder.
The changes I regarded as positive they regarded as symptoms of
'mental illness'. They urged me to consult a psychiatrist. I had done
some reading in psychology but, while finding a number of valuable
ideas, had rejected its overall apprach as being too narrow -
psychotherapy was not for me. For more than two years the struggle
between my parents and me intensified. Eventually, because I wouldn't
see a psychiatrist, my parents decided to force the psychiatrists on me.

The way that was and still is being done in our society is by
commitment, a euphemism for psychiatric incarceration. I was locked
up at Mt. Zion Hospital in San Francisco on October 17, 1962.
During the same week that the world's attention was focused on the
Cuban Missile Crisis and the possibility of nuclear war, two physicians
in a San Francisco hospital were focused on me and the possibility on
my being mentally ill. They decided I was and gave me a 'tentative
diagnosis' of 'schizophrenic reaction'. The case-history section of the
'Certificate of Medical Examiners' they signed reads af follows:
'Reportedly has been showing progressive personality changes over
past 2 or 3 years. Grew withdrawn and asocial, couldn't or wouldn't
work. Grew a beard, ate only vegetarian food and lived life of a beatnik
- to a certain extent'.

'Symptoms' Listed

On October 20 I was sent to Napa State Hospital, northeast of San
Francisco, where I remained through the first week of June 1963.
Early on, I was diagnosed as a 'paranoid schizophrenic', a label
reserved not only for serial killers but also for almost anyone else in a
mental institution who refuses to knuckle under to psychiatric authority.
Scattered throughout my medical records, 143 pages of which I
obtained in 1974, were the 'symptoms' and observations that according
to psychiatric ideology, supported the diagnosis. These included
'condescending superior smile'; 'vegetarian food idiosyncracies';
'apathetic, flat effect'; 'has a big black bushy beard and needs a
haircut, he is very sloppy in appearance because of his beard';
'refuses to shave or accept innoculations or medication'; 'patient
declined to comment on whether or not he thought he was a mentally ill
person'; 'no insight'; 'impaired judgement'; 'stilted, brief replies, often
declines to answer, or comment'; 'autistic'; 'suspicious'; 'delusions of
superiority'; 'paranoid delusions'; 'bizarre behavior'; 'reclusive';
'withdrawn, evasive and uncooperative and delusional'; 'negativism';
'passively resistive'; ''piercing eyes'; and 'religious preoccupations'.
Soon after being imprisoned, psychiatrists tried to gain my consent
to shock treatment - at first electro-convulsive treatment (ECT) but
after being transfterred to Twin Pines, 'combined insulin
coma-convulsive treatment'. When I was 'extremely resistive' to
undergoing the latter procedure, the hospital filed for a court order
authorizing force in administering it. In the closing paragraph of the
seven paragraph letter to the court, the treating psychiatrist wrote, 'In
my professional opinion, this man is suffering from a
Schizophrenic Reaction, Paranoid Type, Chronic, Severe, but it is felt
he should have the benefit of an adequate course of treatment to see
if this illness can be helped. In view of the extremes to which the
patient carries his beliefs it is felt that the need of hospitalization and
treatment under court order is a necissity as he is dangerous to himself
and others under these circumstances'.

On January 10, 1963, after a hearing at which I was present, the
Superior Court of California in San Mateo County 'ordererd (me)
committed to Twin Pines Hospital.' The next day, the series began;
there were in all 50 insulin coma treatments (ICT) and 35
electro-convulsive treatments.

Combined insulin coma-convulsive treatment was routinely
administered to 'schizophrenics' in the United States from the late
1930's through the mid 1960's. ECT was sometimes applied while the
subject was in the coma phase of the ICT; sometimes the procedures
were administered on separate days. Individual insulin sessions lasted
from four to five hours.
Large doses of injected insulin reduced the blood's sugar content
triggering a psychological crisis manifested in the subject by blood
pressure, breathing, heart, pulse, and temperature irregularities;
flushing and pallor; inconntinence and vomiting; moans and screams
(referred to in the professional literature as 'noisy excitement'); hunger
pains ('hunger excitement'); sobbing, salivation, and sweating;
restlessness; shaking and spasms, and sometimes convulsions.
The crisis intensified as the subject, after several hours, went into a
coma. Brain-cell destruction occured when the blood was unable to
provide the sugar essential to the brain's survival; the sugar starved brain then began feeding on itself for nourishment. The hour-long
coma phase of the procedure ended with administration of
carbohydrates (glucose and sugar) by mouth, injection, or stomach
tube. If the subject could not be restored to consciousness by this
method, he went into what were called 'prolonged comas', which
resulted in even more severe brain damage and sometimes death.

According to the United States Public Health Service Shock Therapy
Survey (October 1941), 122 state hospitals reported an insulin coma
treatment mortality rate of 4.9 percent- 121 deaths among 2,457
cases.(1)

After gaining my freedom, I tried to find out how psychiatrists
justified their use of ICT. One of the clearest statements I uncovered
came from Manfred Sake, the Austrian psychiatrist who introduced the
insulin method in 1933 and, after arriving in the United States a few
years later, became its most active promoter. In a popular book on the
stat of psychiatry published in 1942, Dr. Sakel was quoted as follows:
'With chronic schizohrenics, as with confirmed criminals, we can't hope
for reform. Here the faulty pattern of functioning is irrevocably
intrenched. Hence we must use more drastic measures to silence the
dysfunctioning cells and so liberate the activity of the normal cell. But
can we do this without killing normal cells also? Can we 'select' the
cells we wish to destroy? I think we can'.(2)

Lost Memories

I didn't see it that way. For me, combined insulin coma-convulsive
treatment was an attempt to break my will, to force me back to an
earlier phase of my spiritual and intellectual development. It was also
the most devastating, painful, and humiliating experience of my life.
Afterwards, I felt that every part of me was less than what it had been.
Except for memory traces, some titles of the many books I had read,
for example, my memory for the three preceding years was gone. The
wipeout in my mind was like a path cut across a heavily chalked
blackboard with an eraser. I did not know that John F. Kennedy was
president although he had been elected two and a half years earlier.
There were also big chunks of memory loss for experiences and events
spanning my entire life; my high school and college education was
effectively destroyed. I came to believe that shock treatment was a
brainwashing method. Some years later, I found corroboration for this
in a professional journal describing ECT's effect on patient by two
psychiatrists-proponents of the procedure: 'Their minds are like clean
slates upon which we can write'.(3)

Aside from being a flat-out atrocity, the use of combined insulin
coma-convulsive treatment necessarily involved the violation of certain
human rights; some are proclaimed in the Bill of Rights, all are
cherished in a free society:
'Freedom from "cruel and unusual punishments" (Eighth
Amendment)'. If insulin coma treatment is not a torture, nothing is.
Readers of professional literature, however, receive barely a hint of this
reality. The barbaric aspects of this procedure, if mentioned at all, are
glossed over in understatement and euphemism. For example, one
psychiatrist cautioned against allowing new insulin patients to see
other patients further along in their treatment, thus saving them 'the
trauma of sudden introduction to the sight of patents in different
stages of coma - a sight which is not very pleasant to an unaccutomed
eye'.(4)

I recall the horror of coming out of the last coma: severe hunger
pains, perspiration, overwhelming fear and disorientation, alternating
phases of unconsciousness and consciousness, strangers hovering
over my strapped-down body (none of whom I recognized although I
had been thrown in with them months before), being punctured with
needles, heavily sugared orage juice ravenously drunk, and later being
held up by one or two attendants in a shower where the filth was
washed away. Brain damage caused by the treatments destroyed my
memory of what previous sessions had been like.


However, I remember what happened a week or two after
completing my series when, having returned for lunch from
'occupational therapy', I was sitting in the day room that was separated
from the insulin-treatment area by a thick metal door. Suddenly I heard
an indescribable, otherworldly scream. The metal door had been left
slightly ajar and one of the new patients, a young musician, was
undergoing insulin coma down the corridor on the other side of that
door, and he was venting his pain. Almost immediately an attendant
shut the door tight, but the scream, now muffled, lingered on for
another few seconds. I don't recall any of my own screams; I will never
forget his.

'Freedom of Thought (implicit in the First Amendment)'. The words
of Oliver Wendall Holmes Sr. ring as true today as when he first wrote
them in 1860: 'The very aim and end of our institutions is just this: that
we may think what we like and say what we think.'(5) The
brain-damaging force of insulin coma is second only to the lobotomy
operation; it impedes the ability to think, to create, and to generate
ideas. Every ICT survivor experiences impaired thinking and knows
what it means to lose memories, words (you have the idea but can't call
to mind the word to fit it), and trains of thought - not just once in a
while, but repeatedly, hour after hour, day after day, I have keenly felt
these losses.

'Freedom of religion (First Amendment)'. As noted previously, the
phrase 'religious preoccupations' was among the symptoms recorded in
my psychiatric records. One of these preoccupations concerned my
beard, which the staff at both Napa State and Twin Pines Hospitals
had been urging me, without success, to remove. In the midst of the
series - after I had undergone 14 insulin treatments and 17
electroshocks - the treating psychiatrist wrote my father, 'In the last
week Leonard was seen by the local rabbi, Rabbi Rosen, who spent a
considerable period of time with him discussing the removal of the
beard. I felt it was desirable to have the rabbi go over it with him, as
Leonard seems to attach a great deal of religious significance to the
beard. The rabbi was unable to change Leonard's thinking in this
matter.'

At this point, the San Francisco psychiatrist who had been advising
my father was brought in to interview me. After noting in the 'Report of
Consultant' that I was 'essentially as paranoid as ever,' he
recommended that 'during one of the comas his beard should be
removed as a therapeutic device to provoke anxiety and make some
change in his body image. Consultation should be obtained from the
TP (Twin Pines) attorney as to the civil rights issues - but I doubt that
these are crucial. The therapeutic effort is worth it - inasmuch that he
can always grow another'. On March 11, the 'Doctor's Orders' read:
'Pts beard to be shaved off & to be given hair cut - Observe very
carefully today & tonight for any unpredictable behavior re suicidal or
elopement (escape) REJ.' The same psychiatrist wrote my father ten
days later, 'Leonard's beard was removed this last week which caused
him no great amount of distress...' The shock therapy in combination
with the beard shaving therapy 'worked': I was soon shaving on my
own. I have no direct memory of struggle over my beard or of even
having had a beard during this period.

'Right to be let alone.' In a 1928 Supreme Court decision (Olmstead
v United States), Associate Justice Louis D. Brandeis wrote, 'The
makers of our Constitutuion...conferred, as against the Government,
the right to be let alone - the most comprehensive of rights and the
right most valued by civilized men.' Without having been proved guilty
of violating anyone else's rights, I had been deprived of my freedom
and made to undergo corporal punishment disguised as medical
treatment. In the truest sense of the term, I was minding my own
business, exercising my right to be let alone. As a young man, I
thought that in the United States this right was protected. I was
wrong. That was 40 years ago, but it's still happening as literally
millions of innocent people every year are being locked up, for short and
long periods of time, in psychiatric facilities where their rights are
trampled on and they are subjected to psychiatric treatment against
their will or without their fully informed consent.

Aside from the serious and permanent memory loss, other effects of
those nearly eight months of confinement and forced treatment include
a general slowing of the thought processes and a loss of drive and
stamina. But, by psychiatric standards, I am still 'essentially as
paranoid as ever'. I still have my 'vegetarian food idiosyncracies'. I
have regrown my 'big black (now greying) bushy beard'. And, what is
more, I have maintained all my 'religious preoccupations'. "
----------------------------------------------------------------------------------------------


bibliography:

1. Franklin G. Ebaugh, "A review of the Drastic Shock Therapies in
the Treatment of the Psychoses," Annals of Internal Medicine, March
1943, p. 294.
2. Marie Beynon Ray, “Doctors of the Mind: The Story of Psychiatry”
(Boston: Little, Brown, 1942), p. 250
3. Cyril J.C. Kennedy and David Anchel, "Regressive Electric-Shock
in Schizophrenics Refractory to Other Shock Therapies", Psychiatric
Quarterly, vol. 22, 1948, p. 318
4. Alexander Gralnick, "Psychotherapeutic and Interpersonal
Aspects of Insulin Treatment”, Psychiatric Quarterly, vol. 18, 1944, p.
187
5. Oliver Wendal Holmes Sr. "The Professor at the Breakfast Table"
(New York: E.P. Dutton, 1931 (1860), chapter 5

"Intelligence is quickness in seeing things as they are."
- George Santayana