From the 1930’s to the 1960’s, early attempts to combine the psychiatric goals of restoring mental health with new advances in medical science would produce tragic results for many of those who trusted modern psychiatry to provide comfort and healing. During this time, science, psychiatry, ambition, power, and politics came together to leave behind a controversial history of events that destroyed the trust and hope placed by many upon modern science and left behind a trail of scarred minds and ruined lives.
When Allen Ginsberg, the famous Beat poet, attacked the American mental health care system of the 1950’s in his poem, “Howl”, he knew the subject well. These experiences, which he described as “memories and anecdotes and eyeballs kicks and shock of hospitals”, were vivid, yet accurate descriptions of psychiatric practices of the time (Ginsberg 50). Both Ginsberg and his mother, Naomi Ginsberg, had been committed to mental hospitals.
Tragically, his mother would spend her most of her final years as a resident of New Jersey’s Greystone and New York’s Pilgrim State mental hospitals, often heavily sedated with medication, then finally lobotomized (Asher). Lobotomies In 1936, Egas Moniz, a Portuguese neurologist, introduced the world to a radical new procedure to treat the mental illness of schizophrenia. This procedure was a surgical operation performed on the brain, called a prefrontal leucotomy and would become more commonly known as the lobotomy.
The operation consisted of the insertion of a needle to perform incisions that destroyed connections between the prefrontal region and other parts of the brain. This helped to reduce incidents of the negative behavior, but often left the patient with little or no emotional responses (Jansson). Moniz was a well-respected leader in the field of neurology, having held the academic chair of neurology at the University of Lisbon. He completed his postgraduate studies in Bordeaux and Paris, under some of the foremost neurologists of his time (Critchley).
He was active in Portuguese politics, as a member of the Portuguese Parliament, as the Portuguese foreign minister to Spain in 1917 and as President of the Portuguese delegation to the 1918 Paris Peace conference (Nobel). With his professional reputation behind this new procedure, it would soon see widespread use. For his pioneering work in his field, Moniz was awarded a Nobel Peace Prize in 1949 (Jansson). The results of the lobotomy seemed positive at first.
An English study indicated that 9,284 of the patients surveyed showed that 41% had recovered or were greatly improved while 28% were minimally improved, 25% showed no change, 2% had become worse and 4% had died (Jansson). However, the stories about those who underwent the procedure began to draw the public’s attention to the human cost. As Allen Ginsberg grew up, he watched his mother fight a losing struggle with mental illness. Louis Ginsberg, Naomi’s husband and Allen’s father, was exhausted by a losing struggle with his wife’s mental breakdown and divorced her.
The years of gradually worsening psychotic episodes resulted in Naomi Ginsberg’s permanent commitment to the Pilgrim State mental hospital in New York (Asher). Ginsberg wrote of his mother’s mental collapse and commitment in his famous poem, “Howl”: “With Mother finally f*****, and the last fantastic book flung out of the tenement window and the last telephone slammed at the wall in reply and the last furnished room emptied down to the last piece of mental furniture. ” (Ginsberg 53)
Desperate to get his mother’s violent behavior under control, Allen Ginsberg, along with his brother, Eugene, consented to allow a lobotomy to be performed on their mother (Asher). Allen Ginsberg chronicled the experience of watching his mother’s continued mental decline in his poem, “Kaddish”: “One hand stiffheaviness of forties & menopause reduced by one heart stroke, lame nowwrinklesa scar on her hard, the lobotomyruin, the hand dipping downwards to death. ” (Ginsberg 107) Rosemary Kennedy, sister of President John Kennedy and U. S.
Senator Ted Kennedy, underwent a lobotomy in 1941. Unable to cope with his daughter’s aggressive and violent behavior, Joseph Kennedy arranged for his daughter to undergo the surgery. The surgery left Rosemary unable to live a normal life, and she would end up a permanent resident at St. Colletta’s Convent, in Wisconsin. This episode remained a sore point within the Kennedy family, as Joseph Kennedy had acted without consulting other family members first (Sabbatini). Frances Farmer was a young rising movie star in the 1930’s and 1940’s.
A political activist with communist sympathies, Farmer was considered to be very rebellious and had several run-ins with authorities, until her parents had her declared mentally incompetent and committed in 1942. After spending several years in a series of hospitals and asylums, Farmer’s condition showed no signs of improvement. In October 1948, Walter Freeman, who helped introduce the lobotomy to American medicine, performed a transorbital lobotomy on 34 year-old Frances Farmer. In 1953, she was considered to no longer be a threat to society and released, but her movie career was over.
No longer a Hollywood celebrity, with a diminished mental capacity, Farmer would be consigned to live a low-key existence, supporting herself with odd jobs, until she died of cancer in 1970 (Sabbatini). In 1952, the introduction of the drug chlorpromazine gave doctors the first medicine that allowed them to control schizophrenia without resorting to surgery. With a more effective and less scarring tool at their disposal, psychiatry would embrace this and other medicines that followed. As a result, the use of lobotomies would begin to decline substantially (Jansson).
Electro-Shock Treatment Science added another controversial tool for the profession of clinical psychiatry with the introduction of shock treatment, also known by the medical terms “electro-convulsive shock therapy”, “electroshock therapy”, or ECT (Eastgate 29). Like the lobotomy, this form of treatment first appeared in the 1930’s and saw widespread use in the United States during in the 1940’s and 1950’s. Ugo Cerletti, an Italian psychiatrist, first tested ECT on humans in 1938. Soon thereafter, the procedure would first see widespread use in Nazi Germany.
It was used by German psychiatrists who were seeking to prove the incurability of mental illness, as a justification for their elimination from society (Eastgate 29). Physicians Lothar Kalinowsky and Leo Alexander, both of whom were trained in Germany, pioneered electroshock therapy in the United States. Unlike in Germany, the practice came under early fire. By 1940, at least 20 percent of electroshock patients were found to have suffered fractures of the vertebrae due to violent convulsions while undergoing shock treatment (Eastgate 29).
Reports emerged of the procedure being used for punishment at some state mental asylums, including some in Georgia (Shorter 282). After completing post-World War II interrogations of Nazi German doctors and psychiatrists for the Nazi War Crime tribunals, Leo Alexander would return to the United States to continue his work in the field of ECT. He would lead the United States Electroshock Research Association in 1951 and 1952 (Eastgate 29). In 1961, suffering from depression, Ernest Hemingway, the Pulitzer Prize-winning author, was placed on a regimen of electroshock treatment twice a week by his doctors (Ferrell 214).
Complaining about electroshock therapy “ruining my head and erasing my memory”, Hemingway sank deeper into depression (Eastgate 30). After several suicide attempts, Hemingway was placed into a clinic in May of that year. In late June he was released, and on July 2nd, Hemingway took his own life with a shotgun (Ferrell 215). Soon after Hemingway’s death, a public outcry rose against the ECT. Patients’ rights groups attacked the abuses and negative effects of the procedure, pushing many states to respond with various initiatives. In 1967, Utah became the first state to pass legislation regulating electroshock therapy.
By 1983, 26 states had passed regulatory statutes, six states had begun administrative regulation, and one state was regulating the procedure under a federal court order (Shorter 283). The ghosts of electroshock’s past live on and the procedure still sparks considerable debate. Writing in the November 1998 issue of USA Today Magazine, Jan Eastgate, president of the Citizens Commission on Human Rights International, warns readers of the continued dangers of ECT: “For years, mothers have been telling children not to put their fingers in electrical outlets.
Psychiatrists expect you to put your brain in one. Any five year old knows better” (Eastgate 30). Lobotomies and Electroshock in Literature and Movies The human toll of these new psychiatric procedures became the stuff of Hollywood. Dark stories of human destruction at the hands of science gone astray seemed ready made for moviemakers. In 1962, Ken Kesey, another American Beat poet, wrote One Flew Over the Cuckoo’s Nest, a dark tale of a mental hospital where electroshock and pills are used as punishment and control tools, instead of being used to help the patients return to sanity (KKMP).
Kesey had a deep history of involvement in the Beat movement, traveling with fellow beat poet Neal Cassady and linking up in San Francisco with Allen Ginsberg, as part of Kesey’s Acid Test Festivals (Asher). In 1959, Kesey volunteered to participate in government LSD testing while a graduate student at Stanford University (KKMP). Kesey’s novel tells the story of McMurphy, a rebellious prison inmate with a history of escapes who is placed in a mental hospital and breaks the monotony of the dreary environment with pranks and rebellious stunts.
McMurphy, played by Nicholson, was eventually lobotomized by staff members tired of dealing with his rebellious, but usually harmless acts, and was later killed by another patient in the hospital (Adull). Critically acclaimed, Kesey’s novel would be turned into a movie version in 1975, which starred Jack Nicholson and Danny DeVito (Shorter 283). The story of Frances Farmer would also live on in the entertainment world. Her life’s story would reach the big screen in the movie “Farmer”, starring Jessica Lange.
The 1990’s rock band, Nirvana, recorded the song “Frances Farmer Will Have Her Revenge on Seattle” (Sabbatini). Conspiracy Theories: The Nazi and CIA Experiments While many in the mental health fields were working towards the goal of improving the lives of their patients, some had a more sinister agenda behind their research. Both the Nazi German government and the American Central Intelligence Agency conducted psychiatric experiments upon human subjects in years past. Nazi Germany conducted a number of experiments with psychiatric medicine.
German psychiatrists used film footage of electroshock tests in a movie entitled “The Mentally Ill”, which attempted to portray the mentally ill as incurable and justify their execution by poison gas, as a prelude to the horrors of Hitler’s “Final Solution” (Eastgate 29). During the Nuremberg trials at the end of World War II, the American electroshock pioneer, Leo Alexander, returned to Germany to question Nazi doctors and studied their research as a consultant to the Allied war crime prosecutors.
In 1945, he published these findings in his report, “Public Mental Health Practices in Germany: Sterilization and Execution of Patients Suffering from Nervous or Mental Disease” (Eastgate 29). On August 20, 1947, the Nuremberg War Crimes Tribunal handed down sentences in what became known as the Doctors Trial. Seven doctors were sentenced to death by hanging, and six others were given prison sentences, up to life terms. Seven other indicted doctors were found not guilty (TDTS).
The first official United States government effort in exploring mind control techniques was code-named Bluebird in 1950 (Weinstein 128). Project Artichoke followed Bluebird in 1953, which then evolved into Project MKULTRA (Weinstein 129). MKULTRA was a CIA-funded mind control research project that lasted from 1957 until 1961. Conducted under Dr. Ewen Cameron at the Allan Memorial Institute at McGill University in Montreal, Canada, this project covered a broad range of experiments in mind control techniques (Weinstein xvii).
Much of Cameron’s research into changing behavior was based upon finding the tools to return a patient to more primitive and childlike behavioral state, then rebuild the patient by introducing new behavioral patterns (Weinstein 110). Cameron had written a paper in the American Journal of Psychiatry in 1953, where he argued the theory of “driving”, where a properly-conditioned patient could be controlled and directed with simple, regularly played audio tapes (Weinstein 131).
To open his patients’ minds to suggestion, Cameron employed a number of approaches to produce a sense of disinhibition with patients, including the use of the drug sodium amythal, stimulant drugs such as amphetamines, twenty or more hours of sleep daily, blinding them with goggles, and the hallucinogenic drug, LSD (Weinstein 111). By 1960, Cameron also added the use of the drugs PCP and curare to help immobilize patients (Weinstein 119). In 1961, Project MKULTRA was deemed a failure by the CIA and ended (Weinstein 143).
But for some of the patients in Cameron’s experiments, the ghosts would linger on, requiring many years of further treatment to overcome debilitating anxiety problems it created in many patients (Weinstein 160). Details of MKULTRA surfaced in August 2, 1977, when the New York Times published a front page story about Project MKULTRA, detailing the lengthy research of Cameron and others, as well as the intricate network used by the CIA to launder monies used to fund the research (Weinstein 130).
With these revelations to back up their claims, some of the MKULTRA patients began a lengthy and intensive court battle. Finally, on Tuesday, October 5, 1988, the CIA reached a settlement awarding eight of Cameron’s patients $750,000 each. However, a carefully worded CIA statement claimed the settlement “does not represent a concession of liability on the part of the agency” (Weinstein 270). Winds of Change Advances in medical knowledge have allowed electroshock therapy and lobotomies to be used more precisely, rather than the blunt instruments of punishment or permanent disability they have been in years past.
The use of these procedures in conjunction with other treatment tools has opened up new avenues in psychiatric treatment. Electroshock therapy has returned, but this time, the procedure is often combined with the use of medication or other treatments. A report issued by the American Psychiatric Association in 1990 stated “ECT is an effective treatment for all subtypes of unipolar major depression”. However, the use of electroshock as a treatment tool remains limited.
In a 1988 survey, less than one in ten psychiatric professionals questioned admitted to employing the procedure in the past month (Shorter 285). Lobotomies are still being performed, but in greatly reduced numbers than in the time of Ginsberg’s “Howl”. While an estimated 50,000 lobotomies were performed in the United States between 1939 and 1960, there are only two to three hundred performed annually around the world today (Rodgers 36).
Thanks to advances in medical science, these procedures are now performed with greater precision. Like modern electroshock treatment, they are often being used in conjunction with medication and other treatments to accomplish the desired outcome (Jansson). Scientific advancements and reforms in the practices of the American mental health profession have helped to reign in the abuses and dangers of these procedures, while helping to provide more effective treatments for those suffering from mental illness.
These changes are helping make Allen Ginsberg’s harsh words seem more like attacks of poetic license, rather than reminders of a terrible period in psychiatric history. However, the roles of Ginsberg and others played in bringing greater public awareness of these problems cannot be forgotten. Humanity cannot afford to forget those years where science, ambition, power, and ignorance came together to produce such a scarring experience upon those who came seeking healing and comfort.
