Dr. Debray also cites the case of two twins (whom he designates as A and B), aged twenty-four, who presented exactly the same symptoms of obsessive compulsive disorder in regards to cleanliness.
‘A has not been on the bus for fifteen years. He cannot touch a floor, which could be contaminated by unknown feet. He makes complicated calculations in order to avoid all the objects that may have been contaminated: he cleans or washes coins and banknotes that appear suspect. If he feels contaminated, he immediately washes his hands, his body, and his clothes according to laws prescribed by B. Defecation is done naked and followed by a bath or a shower. Complicated precautions are taken regarding the cleanliness of the bed. Obsessive doubts occur about the perfection of rituals, so much so that during a stay in the United States, A called his brother across the Atlantic by phone to enumerate the details of his bathroom. He refused an excellent opportunity because he had heard that a dog had entered the establishment’.
‘B is undoubtedly still more affected. He cannot talk to a contaminated friend for several months, even by phone. If this happens, it is washed completely. He cannot empty his rubbish himself. Like his brother, he keeps his room perfectly clean and forbids access to anyone’.
In 1965, a study by a Scottish doctor, Patricia Jacoba, on a population of serious offenders, revealed that a much higher proportion of ordinary criminals than could have been expected were suffering from a ‘chromosomal aberration’, the XYY syndrome, characterised by the presence in the organism’s cells of an extra (‘masculine’) Y gonosome.
Dr. Quentin Debray comments and clarifies this study, which at the time caused great controversy. (One spoke, a little hastily, of the ‘chromosome of the crime’). He compared the illness in question with Klinefelter syndrome, characterised by an absence of the Y chromosome in a male subject of ambiguous sexual appearance. ‘Klinefelter’s syndrome’, he writes, ‘a non-inherited chromosomal aberration, is accompanied by a tendency to delinquency and criminality. There is an imbalance to the perversions, which are not just any perversions, because the frequency of sexual assault and child killing is more pronounced than in average offenders and criminals’.
Each mental condition is so reviewed. At the end of the book, Dr. Debray offers the reader a small concluding diagram. In black, the parts corresponding to diseases where the genetic element intervenes without doubt. In white, what seems conditioned (the circumstances that can precipitate the disease on a predisposed ground).
Treatable Diseases
In the first of these categories we must place schizophrenia, intellectual retardation, manic-depressive psychosis, then anxiety, psychopathic imbalances, homosexuality (there is an innate homosexuality, of genetic origin, alongside an acquired, reactive, often neurotic homosexuality). In the second: anorexia nervosa, neurotic depressions, and especially hysteria.
‘Not everything is genetically determined in psychology’, writes Professor Jerôme Lejeune in his preface. ‘Far from it. But what is truly surprising is that so many things are, and that so little of it is perceived’.
‘The objections to genetics’, adds Debray, ‘do not exist in medicine, because there is no disputing the experiments and the statistics’. In fact, with the exception of the anti-psychiatrists, reluctance only comes from Marxist theorists, who believe that the individual can be transformed by eroding social differences (psychometric tests aimed at measuring intelligence have been prohibited in the USSR since 1936). And psychoanalysts, who doubtless remember the word of Freud: ‘The doctrine of drives is, so to speak, our mythology’.
The public should still be properly informed, but this is not always the case. Many, for example, believe that ‘genetic’ means ‘inevitable’. But the opposite is true. ‘For the geneticist’, explains Professor Lejeune, ‘the knowledge of the transmission mechanism of diseases is only a first step, indispensable to the precise delimitation of a morbid entity. For, when this individualisation has been achieved, it becomes possible to thwart the pathological mechanism, since in the end any genetic defect necessarily implies a precise metabolic disorder’.
The way is thus open to eugenic information and prevention, as well as to genetic prophylaxis. (In Germany, the first clinic for genetic disorders opened in Marburg). The disorder becomes accessible to treatment when it can be determined with precision. In the immediate future, research is oriented towards the development of biochemical tests upon blood, urine, and the cerebrospinal fluid (which bathes the central nervous system). We thus hope to be able to detect the metabolic symptoms of the principal disorders.
Biochemistry is therefore called upon to play an essential role in the identification and treatment of mental illnesses. ‘Psychiatry’, says Dr. Abramow, ‘will then resolutely emerge from esotericism and magic, where it has been relegated for far too long’.
*
Génétique et psychiatrie, by Quentin De-bray. Fayard, 237 pages, 45 francs.466
La schizophrénie, by Georges Heuyer. PUF, 230 pages, 32 francs.467
Psychiatrists in the Asylum
‘There is a man who walks around a public garden. From the outside. Now and then he shakes the garden’s fence and cries: ‘Why have they locked me up?’
Normal people love stories about crazy people. This could be used to introduce anti-psychiatry.
‘The insane asylum, the psychiatrist, psychiatry — all flourished and prospered with bourgeois capitalist society in the second half of the nineteenth century, and a little at the beginning of this one. All of this is in the process of deteriorating, but it is a little foolish to die late’.
It is in these terms that Roger Gentis, author of Murs de l’asile (Maspéro, 1971),468 a psychiatrist and adept at anti-psychiatry, sets out his convictions. Since the great era of structuralism (1967–1970), intellectual leftism crystallised around two poles: anti-pedagogy and anti-psychiatry. The same influences are found: Rousseau’s utopianism, existentialism and phenomenology, ‘Freudo-Marxism’ (Wilhelm Reich), neo-structuralism (Foucault, Lacan), and the inevitable ‘Frankfurt school’ (Marcuse, Bloch, Adorno). The affair is no longer in its infancy. It is necessary to pay attention.
‘Social Alienation’
It all began in London during the sixties. A group of ‘neo-psychiatrists’, apparently more expert in philosophy than medicine, decided to ‘disrupt’ the profession. Three names immediately stand out. David Cooper (Psychiatry and Anti-psychiatry. Paladin, 1967),469 Aaron Esterson (Sanity, Madness, and the Family: Families of Schizophrenics. Penguin, 1964),470 and especially Ronald D. Laing.
‘It was Laing who opened our eyes’ says Harold Heyward. Fifty years old, tired eyes, black shoulder-length hair, Mr. Laing has the curiously asymmetrical face of the first offender. He began by studying psychoanalysis and schizophrenia. He then plunged into Jean-Paul Sartre, before leaving for Kathmandu.
At first glance, anti-psychiatry seeks to present itself as a more ‘humane’ therapy. A praiseworthy concern; but it collapses as soon as we discover the two great postulates which inspire it: (1) There are no mentally ill people; (2) it is society that makes us mad.
The word ‘crazy’ (mad, foolish), vulgarised by common language (to be ‘madly in love’, to ‘act the fool’),471 corresponds to a precise reality for clinicians. Beyond the wall of psychosis, there is a rupture between the ‘normal’ brain and the brain of the mentally ill. A complete rupture. For anti-psychiatrists, on the contrary, the boundaries of ‘normality’ are purely conventional.
‘The mental state of those who are called “normal”’, writes Silvio G. Fanti, ‘is almost the same as those who are locked up’. Cooper claims: ‘It is often when people start to become healthy that they enter a psychiatric hospital’.
Here, anti-psychiatrists use the theory of ‘alienation’ (Karl Marx), which they seek to renovate by speculating on the ‘repressive nature’ of the modern institutions of family (Freud), society and politics (Marcuse, Reich).
Accordingly, madness is therefore n
ot a state. It is at most a status. A ‘response’ to existing society. A means of ‘defending’ oneself against a ‘repression’ which is even subtler because it advances in a masked form. And since this reaction is ultimately very healthy (from the point of view of this contestation), all accepted realities must shift into their opposites. ‘The “normal” are thus truly “insane”, that is, alienated from a false reality’, writes Gilbert C. Rapaille, ‘whereas the “insane” are those who resist this alienation’.
The insane person thus becomes the accuser par excellence, and even an index for the madness of ‘others’ (normal people). For they are only alienated by society, whereas the ‘normal’ are probably alienated by their normality (which is a madness that ignores). In short, we cannot escape it.
Anti-psychiatrists make extensive use of quotation marks. They always place them around ‘madness’. ‘Mental illness and all the social practices that it involves’, says Hayward, ‘is fabricated in every instance from the myth of mental illness’. Schizophrenia, in particular, far from being a hereditary illness, will be ‘the consequence of a whole series of repressions perpetrated by family and society’ (special issue of La Nef on Anti-Psychiatry, January–May 1971).
A Major Project for the Union of the ‘Marginal’
In 1965, anti-psychiatrists in London set up an ‘experimental community centre’ at Kingsley Hall. Patients and doctors lived together. On equal footing. ‘In this hospital’, says Jean-Michel-Palmier, ‘no constraint is imposed on the sick, there are no tranquilisers, we get up and eat when we want, we make love with who we want. There are no longer any sick people, but individuals who have sought refuge in this community because life has become impossible for them’. But very quickly, difficulties magnified. One of the ‘boarders’ took up the habit of keeping her excrement and smearing it on the wall of her room, which adjoined the kitchen. ‘There were meetings’, indicates one of the doctors of the center, ‘to decide whether or not that person had the right to do this, as well as to do whatever she wanted in her room. It was then found that the extent of the smell was greater than the extent of the room. She was asked to reduce the extent of the smear of her excrement’ (La Nef, op cit.)
The ‘experiment’ ended in 1969. A hundred patients found themselves on the street. ‘Such innovations’, says Palmier, ‘have not only raised the indignation of psychiatrists, but also of the residents of the neighbourhood, whose children had become accustomed to stoning the walls of the hospital’.
This is just the beginning. In all western countries, especially in the United States, the anti-psychiatrists wage war against the ‘order of caregivers’ (Maud Mannoni, Le psychiatre, son « fou » et la psychanalyse, a work dedicated to Jacques Lacan).472 Diagnostic practices, which are equivalent to ‘medicalisation’ of social violence, and the resort to medications, which would be a ‘chemical straightjacket’, are denounced as a desire for ‘psychiatric segregation’.
The rest follows suit. The family ‘represses’. Society ‘spreads inequality’. The asylum ‘imprisons’, etc. The psychiatric hospital is a ‘concentration camp’, where doctor-supervisors and nurse-wardens ‘create schizophrenia’. Internment allows society to eliminate its ‘accusers’ — and doctors provide it with ‘alibis’.
Of course, psychiatry is ‘racist’: ‘One says insane like one says negroes, North Africans,473 or Portuguese. From here to extermination, there are only a few short steps’ (Roger Gentis).
It is also castrating. ‘Psychiatrists cut off the speech of the patients, who are transformed by being psychiatrised (which effectively makes them insane), just like we cut off the willy’ (Jean-Paul Dollé).
This politico-mystical approach to the problem, all these dissertations on ‘individual shipwreck’, the ‘difficulty of being’, and the closed universe, do not come without a cost. The enterprise of anti-psychiatry is part of a large ‘Marcusian’ project which consists in uniting all the ‘marginalised’ (eternal students, foreign workers, sexual minorities, residents under house arrest and in psychiatric asylums) because, being the only ones who are ‘non-integrated’, the only ones born of revolution that are still available in society, they can become the spark of revolt and the engine of subversion. Hence the slogan ‘Asylums-prisons: same battle!’
In France, the anti-psychiatrists have several journals at their disposal: Cahiers pour la folie, Tankonala-santé, etc. They are ‘militant’ organs, where the mad ‘reclaim speech’. We read observations like: ‘The only difference between a man and a lobster is that a man cannot masturbate with its claws’474 (Cahiers pour la folie, nr. 8), etc.
Dr. Yves Pélicier, forty-four years of age, an Associate Professor of neurology and psychiatry (University of Paris-V) is the complete opposite of an anti-psychiatrist. He belongs to the ‘Algerian school’ (Jean-Claude Scotto, Marcel Delpretti, Maurice Porot, Henri Luccioni, Henri Dufour, and Robert Escoute, co-authors of a recent manual on psycho-pharmacology) headed by Professor J.-M. Sutter. His aim is to react against ‘the literary fashions and mannerisms of the time’. He has twenty years’ experience.
A Dive into Obscurantism
His book, La psychiatrie comprehensible,475 inaugurated a collection directed by Professor Pierre Debray-Ritzen with the publisher Fayard. He attempted to break free from the ‘bondage of animism’ and to bring clarity where others compounded confusion.
‘With verbose ignorance’, writes Debray-Ritzen, ‘akin to that which surrounded fevers before bacteriology, a proliferous interpretation spread through psychology and psychiatry through the influence of Freud, the philosophical digression, and, more recently, the sophisms of anti-psychiatry. But in the years to come, genetics, biochemistry, experimental psychology, and the identification of unsuspected correlations will demolish these castles of word and sand’.
‘Among certain contemporary psychiatrists’, remarks Professor Léon Michaux, ‘the obscurity of exposition, far from indicating depth of thought according to the coquetry of their intention, only translates to inconsistency’.
Reviewing the various categories of mental illnesses (schizophrenia, paranoia, delusions, dementias, retardations, neuroses, phobias, hysteria, psychoses, depressions, etc.), Dr. Pélicier formally contests the position that society does violence to the patient. ‘In truth’, he writes, ‘it forgets that illness is the first violence, that it actually exists even where no physician can be found to detect it, and that not so long ago, when most mental illnesses were considered a sign of sin, debauchery, of diabolical pacts, of atavism, the fate of patients was scarcely enviable’.
Forgetful of the lessons of Hippocrates, psychiatry had fallen back into obscurantism in the Middle Ages. ‘This era, as fierce as it is grandiose’, says Michaux, ‘is essentially anti-scientific. For psychiatry, it is marked by the return to the supernatural conception of mental illness. The insane person is not sick, he is bewitched, possessed by the devil; deserving no pity, he must be exorcised, even tortured and burnt. It is the time of the witch trials and the Sabbaths. It is also, thanks to collective suggestion, the epoch of epidemics of hysterical religious madness’.
These superstitions will disappear in time. Philippe Pinel (1745–1826) had to wait until 1793, at the height of the Terror, to liberate the residents of Bicêtre Hospital from their chains.
Far from having oppressed the patient, the ‘medicalisation’ of psychiatry has thus marked the beginning of its liberation — the anti-psychiatrists preach a genuine step backwards by declaring the insane ‘possessed’ by society in the same way that the theologians of the Middle Ages called them ‘possessed’ by a demon.
Dr. Pélicier also denounces the myth of ‘good drug’ and the ‘trinket of artificial paradises’. ‘As far as the long-term effects of hashish are concerned’, he writes, ‘they may be summarised by a progressive desocialisation, a detachment from reality, a more or less rationalised homelessness justified by foolish or puerile principles’. He adds: ‘What would Marx think of this
opium, proposed to the people to deliver them?
In a joint essay published under the direction of Dr. Cyrille Koupernik (L’antipsychiatrie, sense ou non-sens ?),476 Dr. Jean-Paul Charrier affirms that the failure of anti-psychiatry is largely due to its schizolatry’.477
In the eyes of anti-psychiatrists, the schizophrenic manifests a particularly exemplary attitude. By seeking to ‘escape’ (internally) from a ‘corrupt’ external world, he gives: the most ‘obvious’ signs of his good health. He becomes the objective ally of ‘subversion’.
‘Schizophrenia’, declares Gilbert C. Rapaille, ‘is only a label given by those who are said to be normal to those whose behaviour seems strange and bizarre to them’.
‘All the ambiguity of antipsychiatry’, observes Jean-Michel Palmier, ‘wavers between a radical negation of the disorder (there are no schizophrenics, says Cooper), and a mystical conception of it (the schizophrenic is a ‘foreign poet in our time’, his illness is a ‘transcendental experience’), asserts Laing.
‘Speculation’, wrote Dr. Marcel Eck (in La Nouvelle Presse médicale)478 ‘seems to support this observation. One has wanted to systematically reject the psychiatric at the expense of the philosophical theories. The nostalgic sense has been lost and the very concept of schizophrenia has been effaced’.
This statement is in line with that of Professor Georges Heuyer: ‘The study of schizophrenia, like that of all other diseases, must be clinical. It must begin and end with the patient. The smallest fact is preferable to all the theories. Bergsonian, phenomenological, and existentialist concepts have contributed nothing to the emergence of the etiology of symptoms, to clinical forms, to evolution and treatment of schizophrenia. Moreover, ‘since Freud, there has not been anything new in psychoanalysis’. Only ‘a pretentious literature and insignificant prattle’.
Thanks to Chemotherapy
Heritage and Foundations Page 38
