Sunday, October 1, 2023

Fit to be Tied (in a Straitjacket)

Korean War vet Randle McMurphy (Jack Nicholson) thought he could control his situation (by transferring from prison to a mental hospital) in 1975’s One Flew Over the Cuckoo’s Nest.

When I look up the word “mad” in my 1984 Webster’s dictionary, the first definition is “afflicted with a mental disorder, or insane.”
The second is “enthusiastic” (as in “mad about something”).
The third definition is “angry and resentful.”
(Some dictionaries on the web switch definitions one and three.)
“Insane” is defined as “afflicted with a serious mental disorder impairing a person’s ability to function.”

We live in social environments, and we function in those environments with varying degrees of success.
People—especially those who live in big cities—are used to living with street people who don’t seem to be functioning well at all.
I lived in New York City from 1972-1999.
While I lived there, I routinely listened to a woman chatting on an imaginary phone in our local Post Office.
I was harangued by a naked woman near Penn Station, and nearly knocked into the street by a homeless man on the Bowery.
On multiple occasions, in Turtle Bay, I saw a man wrapped in blankets clucking like a chicken.
As I walked to work, I concluded that living in New York was like being in a giant pressure cooker, and some individuals couldn’t hack it.

R.D. Laing (David Tennant) addressing his audience in the 2017 film Mad to be Normal.
Michael Gabon and Gabriel Byrne played patients.

Psychiatrist R.D. Laing was known for rejecting surgery, electroconvulsive therapy, and most medications to treat mental illnesses.
He wrote The Divided Self in 1960. (I remember attending one of his lectures, probably in the late 1970’s, and Tennant
s performance brings back memories of that occasion.)
In The Divided Self, Dr. Laing said: 

When I certify someone insane, I am not equivocating when I write that he is of unsound mind, may be dangerous to himself and others, and requires care and attention in a mental hospital. However, at the same time, I am also aware that, in my opinion, there are other people who are regarded as sane, whose minds are as radically unsound, who may be equally or more dangerous to themselves or others and whom society does not regard as psychotic and fit persons to be in a madhouse.

Essentially, Dr. Laing was saying that it’s difficult to determine what behaviors are “mad,” since people are reacting to difficult circumstances.
Sometimes, it can just be a matter of what behaviors we are willing to accept from others, or who is in societal control.

Hollywood movie actress Frances Farmer (Jessica Lange) had strong political viewpoints.
According to the screenplay for 1982’s
Frances, she ended up being lobotomized in a mental hospital.

Dealing with “mad” people is a problem in communities, especially as cities became larger.
It’s disturbing to be physically threatened by “unpredictable” people, and this frequently happens in cities.
However, since curing people was not an option, locking them up in asylums became the solution.
John Higg’s book, William Blake vs. the World, mentions the London Vagrancy Act of 1714.
It dictated that “homeless people who appeared to have lost their reason could be restrained and confined.”

One of Glenda Jackson’s first film roles was as a madwoman pretending to be assassin Charlotte Corday in 1967’s Marat/Sade—about inmates in the Charenton asylum performing a play for French society.

Confining people was the purpose of asylums like Bedlam (the London hospital founded in 1247), and Charenton (the Paris hospital established in 1645).
Bedlam was also once one of London’s leading tourist attractions.
Londoners, and tourists alike, enjoyed the “antics” of unfortunate patients until 1770—when the practice of displaying patients in a “human zoo” officially ended.

Before a person could be confined to Bedlam, an admission form was filled out.
One question was whether the prospective patient was “melancholy, raving, or mischievous.”
Of course, “raving” and “mischievous” patients were more of a problem for madhouse managers, than melancholy ones.
Raving patients often needed to be held in chains, and were sometimes very loud. 

By the late 1700’s, doctors began to experiment more with actually curing mental disease.
George III, the King of England from 1760-1820, was “treated” for his mental illness with bloodletting, being placed in a straitjacket, and caustic poultices.
Other than the introduction of talk therapy and hypnosis (1890s), the treatment of mentally ill people didn’t change much until the introduction of psychosurgery and electroshock therapies in the late 30’s.
In the 40’s, insulin comas were induced are a “cure.”

In 1946’s Bedlam, Nell Bowen (Anna Lee) challenges conditions at the asylum, and is herself committed to the madhouse by evil George Sims (Boris Karloff, on far left).
(Anna Lee played wealthy matriarch Lila Quartermaine for decades in General Hospital.)

Great and Desperate Cures, by Elliot S. Valenstein, tells the story of lobotomy*—and other radical treatments—for mental illness.
Lobotomy (surgical severance of cerebral nerve tracts) was first introduced in 1935; its’ main purpose was to pacify patients.
Electroshock therapy also began to be used around that time, mainly for depression.
Until psychotropic drugs were developed in the 1950’s, these treatments were widely used to control patient behavior.

According to Valenstein’s book—in the four years between 1949-1952—at least 20,000 lobotomies were performed in the U.S. alone.
(However, Britannica says it was more like 50,000.)
Many surgeries were performed by Dr. Walter Jackson Freeman II—a doctor who helped popularize lobotomy, and helped transform it from a hospital procedure to a “simple office” procedure. 

Dr. Freeman performed lobotomies on patients as young as four, and also on dementia patients.
He performed his last lobotomy in February of 1967.
(This was the third lobotomy he performed on this particular patient; he’d also operated on her in 1946 and 1956.)
However, the third time wasn’t “the charm.”
He accidentally caused a hemorrhage, and she died.

Over the years, doctors stopped using icepicks for lobotomies and started directing electrodes into brain targets.
By the time Great and Desperate Cures was published in 1985, lobotomy was in disrepute, but occasional psychosurgeries were being performed.
Forms of psychosurgery, and electroshock, are still being used today, but to a limited degree.

Perhaps, because the surgery involves the human brain—the seat of creativity—creatives have been fascinated by the idea of lobotomy.
In 1966’s A Fine Madness (novel and screenplay by Elliott Baker) poet Samson Shilitoe (Sean Connery) undergoes a prefrontal lobotomy.
Most of us remember 1975’s One Flew Over the Cuckoo’s Nest (based on a 1962 novel by Ken Kesey), which portrays both psychosurgery and electroshock therapy.
In 1994’s The Shadow (set in the 30’s) villain Shiwan Khan ends up with part of his frontal lobe excised.
Martin Scorsese’s 2010 film Shutter Island (set in the 50’s) also deals with this subject, but it would be a crime to explain the plot, if you haven’t seen the film.

Push comes to shove when people assume that they are functioning well enough, but society thinks they are NOT.
That’s when policemen and psychiatrists step in, mentally ill people are killed or seriously injured (sometimes, as they seek help), psychotropic medications are prescribed, and patients were once given electroshock treatments, lobotomized, or placed in padded rooms and straitjackets.

Today, the country is polarized.
On one side there are Trump supporters who believe Democrats are “brainwashed by mainstream media,” and “evil” by nature.
On the other side, there are Independents, Democrats and RINOs who are baffled as to why people still follow a person like Trump.
Terms—like derangement, brainwashed, insane, psychopathic, unstable, crazy, idiotic, mad and evil—are tossed around.
(Listen for these words as you watch Sunday morning news shows.)
Each side can’t figure out why the “other side” thinks the way they do, and so they consider the opposing side’s “strange and unacceptable thinking” to be “mad.”
Thank goodness, TPTB no longer believe “mad thoughts” can be excised through surgery.

*In Great and Desperate Cures, Valenstein describes a lobotomy: “after drilling two or more holes in a patient’s skull, a surgeon inserted into the brain. . .instruments. . . often without being able to see what he was cutting, destroyed parts of the brain.” (Lobotomy was a very imprecise business.)

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