A Mad Tea Party

Okay, back to other matters. I've quoted before from Michael E. Staub's Madness Is Civilization, (Chicago, 2011). Staub also tells how it became known in 1967 that

... a military psychiatrist named Lloyd H. Cotter had conducted behavioral experiments on patients diagnosed with schizophrenia at the Bien Hoa mental hospital in South Vietnam. Cotter’s stated goal was to help these patients, but it was impossible for critics not to read in Cotter’s report an utter disregard for the terror and suffering he must have brought them. In brief, Cotter had become enamored with “operant conditioning,” a technique devised by psychologist B. F. Skinner that suggested that “positive” and “negative” reinforcements could encourage individuals to give up behaviors deemed undesirable. Cotter had also read how psychiatrist O. Ivar Lovaas had withheld food from autistic children to promote a reduction in their antisocial behavior, and decided he would starve his own “difficult-to-activate patients.” Some patients held out for five days without food before they succumbed to Cotter, but the doctor was in the end able to announce that every single patient had finally “volunteered for work.” Yet this was not all. Cotter further administered to recalcitrant patients unmodified electroconvulsive treatments (a technique already illegal in the United States because it meant patients did not receive anesthetics or muscle relaxants and therefore ran a risk of fractured bones and compression injuries of the spine). Undeterred by the frank chance that he might injure his patients, Cotter announced that he’d given “several thousands” of these shock treatments, and that “our objective of motivating them to work was achieved.” And what kind of work exactly were these patients asked to do? It was growing crops for a deployment of Green Berets stationed nearby [124-5].

As I understand it, operant conditioning as B. F. Skinner developed it stressed rewards rather than punishments: "negative reinforcement" was seen as ineffective. But regardless of what Skinner thought, Cotter seems to have been more interested in negative reinforcement. What he was doing really sounds more like human experimentation, of the kind the Nazis were notorious for, than anything therapeutic.

Perhaps you'll argue that Cotter was a lone kook, a mad scientist doing his dirty work in the Vietnamese jungle far from responsible scrutiny, and that he therefore shouldn't be seen as representative of psychiatry in the 1960s. That argument won't work, though, because Cotter published his report not in Soldier of Fortune or Spanking Tales but in the American Journal of Psychiatry, a peer-reviewed professional publication -- which means that his colleagues read the article and concluded that it was a serious contribution to scientific knowledge in the field. According to Staub it was "radical therapists" who were appalled by it, not mainstream psychiatrists.

Staub then discusses another controversial issue from the same period:

In late 1967 another case sparked indignation, this time involving three doctors at Harvard Medical School who had suggested that social and economic factors alone could not explain the violent rioting in Detroit that summer – riots that left forty-three dead, more than a thousand injured, and resulted in over seven thousand arrests. In an oft-cited essay, “Role of Brain Disease in Riots and Urban Violence,” which appeared in the Journal of the American Medical Association, psychiatrist Frank Ervin and neurosurgeons Vernon Mark and William Sweet argued that while it was “well known” that poverty, unemployment, slum housing, and inadequate education underlie the nation’s urban riots,” the “obviousness of these causes may have blinded us to the more subtle role of other factors, including brain dysfunctions in the rioters who engaged in arson, sniping, and physical assault.” There was a strong need for clinical studies to be conducted “of the individuals committing the violence” to determine whether “brain dysfunction related to a focal lesion lays a significant role in the violent and assaultive behavior” of black ghetto dwellers. There was additionally a need, the doctors added, to develop “reliable early-warning tests” to detect and screen for potentially violent offenders. This last research agenda received major grants of more than $600,000 from the National Institute of Mental Health and the Justice Department’s Law Enforcement Assistance Administration, monies designed expressly to study “the incidence of violent disorders in a state penitentiary for men; estimate their prevalence in a non-incarcerated population; and improve, develop and test the usefulness of electrophysical disorders in routine examinations.” There had also to be established diagnostic detection centers that could help to prevent violent outbreaks. The first such center “for the study and reduction of violence” opened at UCLA in 1972 (and received more than a million dollars in state moneys from California governor Ronald Reagan in 1973) [125-6].

(The Journal of the American Medical Association is also peer-reviewed, by the way.)

Staub doesn't mention the vogue for psychosurgery in the same period, nor the role American psychiatrists played in developing new forms of torture, but they had the same intent: to treat dissent and resistance as symptoms of brain dysfunction, and to control subjects' behavior. No psychiatric professional seems to have thought of applying the same concepts and remedies to the practitioners of state violence, not even to the police who attacked Civil Rights demonstrators with clubs, firehoses, and attack dogs, let alone to Ronald Reagan.

It's a safe bet, though, that they would have considered the possibility of brain dysfunction in the demonstrators themselves. Armchair psychoanalysis of white student dissidents was a popular pastime in those days. Commentators like "Sidney Hook, George Kennan, Jacques Barzun, Irving Kristol, Nathan Glazer, and H. Stuart Hughes each offered his own unflattering diagnosis of young radicals’ mental states, identifying all sorts of possible analytic explanations for student radicalism" (168), despite "hundreds of empirical research summaries – most finding student radicals to be well adjusted" (235, note 11)" that indicated otherwise. None of those pundits was qualified to diagnose anyone's mental health, of course.

Later in Madness Is Civilization, Staub briefly mentions Marge Piercy's 1976 novel Woman on the Edge of Time. That story, you may remember, shuttles in time between the 1970s present and a utopian twenty-second century future. The protagonist, Connie, is in a mental hospital and has been drafted for an experiment involving the implantation of electrodes into patients' brains to enable control of their behavior by the doctors. Staub remarks that "in the evil 1970s, however, psychiatrists are sinister figures and the main character is involuntarily committed and diagnosed paranoid schizophrenic" (176). Given the evidence Staub himself has collected, it seems fair to say that many mainstream psychiatrists have been "sinister figures."

Which isn't to say that they all were, only to point out why many people in that period came to distrust the profession. Your psychiatrist might genuinely be trying to help you, or he* might be trying to advance his career, with you as a guinea pig. And even if he did want to help you, he might have no idea how to do so. A lot of empirical research also showed that psychiatric treatment was less effective than placebos or no treatment at all. Remember too that homosexuality was still officially a disease until 1973, and not until this century did the psychiatric profession reject attempts to change sexual orientation as the quackery they were.

Nor am I denying that there are people who are distressed and disabled by what goes on in their minds, or that they shouldn't be helped. It appears that changes in medication have helped some of them, though I retain some skepticism about that since the profession also touted its successes in the days of the talking cure, electroconvulsive therapy, and psychosurgery. I wonder what mainstream practices of today will have to be forgotten another generation down the line.
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*I'm not using "he" generically; in those days most doctors and psychiatrists were male.

The Common Clay of the New West

I'm grateful to the Facebook friend who passed along this image today, for confirming what I'd long suspected: at least some, and probably many, of the vocal opponents of "illegal immigration" can't tell the difference between legal and illegal immigrants. In their eyes, all immigrants are illegal.

The giveaway was the part about "a tax free business for 7 yrs". According to Snopes.com, versions of this claim have been circulating in the US since at least the 1960s:

In Miami, it's Cubans who are said to be getting all these government goodies. In Detroit, it's recently arrived Arabs. And all over the U.S., Asians are rumored to be getting those tax breaks, free shoes, new cars, and interest-free loans.

All those groups are legal immigrants. Hostility toward Latin Americans, which long predates the rise of undocumented workers from south of the border, has more to do with their accents than their immigration status. (And it's not irrelevant that white Americans have treated Americans of African descent as undesirable aliens all along.) Snopes also reports that the same rumors circulate in Australia and England; I'd bet they turn up in non-English speaking countries too.

The part about driver's licenses is also false: only two states, Washington and New Mexico, issue driver's licenses to undocumented immigrants. Nor are these free gifts: applicants must pass the normal test requirements to get a license; LA Police Chief Charlie Beck, who advocates licensing the undocumented in California, says as much, and that such licenses "should differ from those granted to citizens: 'It could be a provisional license, it could be a nonresident license.'" This also indicates that the real target is immigrants, regardless of their status.

I've quoted before this excerpt from Harvey A. Daniels. Famous Last Words: The American Language Crisis Reconsidered (Carbondale: Southern Illinois University Press, 1983):

In Chicago, during the Christmas season of 1978, twenty-six Spanish-speaking people were killed in a series of tragic fires. Many of them perished because they could not understand the instructions that firemen shouted in English. When the city promptly instituted a program to teach the firefighters a few emergency phrases in Spanish, a storm of protest arose. "This is America," proclaimed the head of the Chicago Firefighters Union, "let them speak English." A local newspaper columnist suggested, with presumably innocent irony: "Let's stop catering to the still-flickering nationalistic desires to perpetuate the Latin heritage." The city's top-rated television newscaster used his bylined editorial minute to inveigh against the Spanish-teaching program in the firehouses.

Americans living and working in other countries have no obligation to "learn the language", of course, because they're Americans. (Americans who are good at languages, and are interested in learning them, are widely regarded as freaks or traitors.)

I challenged my friend on this material, and she freely agreed: "How do you tell the difference, they look the same. Just catch them at the borders. Employers need to screen better." She added, "I could use some target practice." Notice that: you can't tell the difference between legal and illegal immigrants, they look the same. (But different from "real Americans," I guess.) As I just pointed out, even legal immigrants (and descendants of people brought here generations ago by force) will be the target of campaigns of lies, alleging that they get privileges that "real" Americans are denied.

There's a lot more wrong in that image, of course: the implication that the US should adopt North Korea, Iran, and Afghanistan as our role models; the fact that people killed at those borders are not immigrants looking for work -- often they're suspect as spies or terrorists, which (contrary to the American racist propaganda) is not true of Mexicans coming north. (Just sticking with Korea, the North and South are still in a state of armed truce, unlike the US and Mexico; and they have a long history of mutual infiltration for sabotage and assassination.) And, of course, immigration, legal or illegal, has nothing to do with the American debt: that's more a product of our own penchant for illegally invading other countries to get their oil.

The crowning irony is that the United States wouldn't exist if not for immigrants, legal or otherwise. Much of our westward expansion involved white settlers who moved illegally onto land that belonged to Indians by treaty, and then demanded that the government ratify their theft. Texas was stolen from Mexico by American immigrants, which I guess is a good argument against letting Anglos onto any land anywhere. If my friend and other nativists really cared about legality, they wouldn't need to augment their complaints by spreading racist propaganda.

The True-Born Englishman

But wait, there's more. I began looking at Owen Jones's Chavs: The Demonization of the Working Class (Verso, 2011), which is about class warfare in Britain. Early on, Jones discusses an ad campaign for an upscale fitness club called Gymbox, which started a self-defense class called Chav Fighting. (A chav -- from a Romany word for "child," according to Jones (2) -- is a lower-class Briton; there are other derogatory terms for non-whites.)

The leaflets for the class included such enticements as "Why hone your skills on punch bags and planks of wood when you can deck some Chavs". The Advertising Standards Authority dismissed complaints on the ground that such classes "would be unlikely to condone or incite violence against particular social groups..." (3); "social groups" presumably referring only to "racial" minorities.

Jones quotes Richard Hilton, the CEO of Gymbox:

They tend to live in England but would probably pronounce it 'Engerland.' They have trouble articulating themselves and have little ability to spell or write. They love their pit bull dogs as well as their blades. And would happily 'shank' you if you accidentally brush past them or look at them in the wrong way. They tend to breed by the age of fifteen, and spend most of their days trying to score 'super-skunk' or whatever 'gear' they can get their teenage hands on. If they are not institutionalized by twenty-one they are considered pillars of strength. in the community or get 'much respect' for being lucky [4].

"And yet, intriguingly, Mr Hilton does not think of himself as a bigot -- far from it. Sexism, racism and homophobia, for example, were 'completely unacceptable," Jones reports (4.)

When travel firm Activities Abroad took heat for promising "Chav-Free Activity Holidays," "'I simply feel it is time the middle classes stood up for themselves,' declared managing director Alistair McLean, "Regardless of whether it's class warfare or not, I make no apology for proclaiming myself to be middle class'" (5). I enjoyed McClean's implication that it takes courage to "proclaim" one's membership in the middle class, against the PC Guardian readers -- also probably middle-class -- who objected to their ads. (Just as it takes courage to admit to being a liberal or a Christian nowadays.) "Activities Abroad exploited resentment against the cheap flights which allowed working-class people to 'invade' the middle-class space of the foreign holiday. 'You can't even flee abroad to escape them these days' -- that sort of sentiment" (5), commented Jones.

This is the kind of thing that makes me dismissive when (usually white) well-meaning Americans argue that the answer to America's racial and ethnic conflicts is to intermarriage, to the point where everybody is the same color. Skin color is a handy divisor, but as the pasty white Brits quoted above reveal, it's really just an excuse. If there were no "racial" differences in the US, others would be invented and exploited. (And remember, many groups now classed as white here didn't used to be: Irish, Italians, Greeks, Slavs, Jews.)

What really intrigues me is the way the same language, the same tropes, are used to demonize whatever group is currently being classified as Them. The parallel to Black English in Hilton's diatribe should be obvious, but don't forget the way white liberals worked themselves into a lather over George Bush's difficulties with pronunciation and syntax. I don't suppose that these themes are "genetic," but it is very interesting how they recur over time and in different contexts: They are dirty lazy animals who breed like rabbits, steal like monkeys, and babble unintelligible gibberish; they don't have language, they don't have morals, they band together and hate all outsiders. They don't belong here, why don't they go back where they came from? (There are echoes of these attitudes in John Preston's contempt for the "sightseers" who defiled the edgy, exclusive world of the leather bar.)

Of course Richard Hilton and Alistair McLean aren't bigots; as my Right Wing Acquaintance would say, they're just trying to protect their culture. But how remarkable that the threat is as true-born as they are. And why do defenders of culture keep falling back on the same giveway themes, regardless of the origin or status of the barbarians at their gates?

A Specter Is Haunting Asia

I've been wanting to write about something other than politics, but this has been on my mind all weekend. Longer than that, really.

We Euro-Americans tend to focus on US foreign policy in Europe and the Middle East, but since the US asserts its dominance over the whole world, it's good to notice what we do elsewhere. Right now the South Korean navy has begun building a base near Gangjeong Village on Jejudo, a large volcanic island off the southern coast the Korean peninsula. There is widespread local opposition to the project, along with solidarity from other Koreans and some well-known foreigners.

This military base, if completed, will be home to both US and South Korean naval vessels and a sea-based Aegis ballistic missile defense system. The proposed location of this base is Gangjeong, a small farming and fishing village that has reluctantly become the site of an epic battle for peace.

The Catholic Bishop of Jeju told the Hankyoreh:

"When the National Assembly cut the Jeju naval base construction budget by 96% late last year, it was voicing the legislature‘s view that there were too many problems with the design and other aspects, and that construction should not be carried out until it had been reexamined.

"I can’t understand why the government is refusing to communicate with the people and making these decisions," the bishop added. We’re not living under a dictatorship."

Jeju was designated the Island of World Peace in 2005 by the South Korean government, with a peace center and museum. It has a troubled history: in 1948, three years after Korea was liberated from Japanese control, at least thirty thousand people were killed in an uprising against the new collaborationist regime in Seoul, supported and overseen by the US. Another 40,000 or so fled to Japan. There's disagreement over the American role in the suppression of the revolt, but there's no doubt that the US was in charge of South Korea at the time.

The New York Times ran a typically clueless article on the controversy, ending with this choice bit:

Speaking about the opponents of the base, Koh Jong-pyo, 47, an abalone fisherman, said: “They worry too much. Think what it could do for the local economy whenever an American aircraft carrier arrives with thousands of sailors and their cash.”

Not everyone agrees with Mr. Koh. As long as he doesn't mind his daughters going to work in bars prostituting themselves to those "thousands of sailors and their cash," fine. Military bases have mixed effects on their neighborhoods, with violent crime including rape accompanying the cash, plus regular "accidents."

There can't be any pretense that the new base is for the "defense" of Jeju, or of South Korea. In an outbreak of hostilities, it would be a prime target of attack, and "collateral damage" would be considerable. Its "purpose, as stated by both South Korean and US military officials, is to project force toward China." Nor is the Jeju base an isolated instance. Imagine how the US would welcome Chinese military bases and missile defense systems in, say, Brazil or Colombia or Venezuela, even though they'd be justified as a means of containing the aggressor state to the north. After all, we welcomed Soviet missiles in Cuba, which were only there to protect Cuba from us.

Assumption

I thought I'd add something about the book I'm reading today, Assumption by Percival Everett (Graywolf Press, 2011), whose work I've written about before. I'm just 50 pages in so far, but I'm enjoying it: Ogden Walker is a small-town New Mexico policeman, the son of a white mother and an African American father. Deaths are starting to pile up in the area, and Walker is trying to figure out what's going on. Straightforward enough.

What interests me about Everett's work so far is his protagonists, who are heterosexual males, not macho but not extremely expressive, educated and intelligent, with full inner lives. That last matters, because I've read too many male characters who seem dulled or apathetic inside, and who don't use the intelligence they're supposed to have. Everett's protagonists are people worth knowing.

Ogden's hobby, which he learned from his late father, is tying flies -- not fishing, but making the lures.

Ogden finally asked his father to teach him to tie, not so much because he wanted to fish, but because he thought the flies were beautiful. He was ten at the time and he still remembered watching his first colorful streamer develop in front of him. He recalled the way ti felt to trim the deer hair on his first grasshopper, the pieces of feathers, how much fun it was to dub the muskrat fur onto the thread with his thumb and index finger ... He no longer felt sad when he thought of [his father]. In fact, the thought of him helped Ogden relax. They had been close, for some reason not having the conflicts his friends had had with their fathers. He wondered if his present profession would have caused a problem between them, in spite of his mother's assurance. He wondered because he himself had a problem with it. He felt out of touch with his time, didn't like people his age. He wasn't like a lot of people who became cops, didn't want to be like them, but then Fragua and Paz weren't like that either. They weren't hard men; some wouldn't even have called them tough, but they did their jobs. Ogden wanted only to do his job [49].

This pleases me because I often encounter recommendations of fiction about men who aren't like this. They are either flat and dull and apathetic, or huge screaming open wounds inside while trying vainly to look tough. The women in their lives fail them, of course, but that's depicted as a failure in the women, not in them. Of course the world is full of such men, but the fiction I've read about them never seems to lead anywhere; worse, it's praised as exemplary. Everett is doing something that works much better for me.

The Intractable Woman

I forgot to include this in last night's post. From Kate Millett's Flying (Knopf, 1974); while Millett was in London, her friend and host the filmmaker Nell O'Rourke told her (312):

"They have taken our anger from us, it's the biggest crime perpetrated against women. Got in touch with mine through that group therapy business. Men and women behave differently in group therapy, you know. Men discover their fear. Women their hostility. Paul was physically attacked in the first group we joined. Look, learn to get angry, stop being humble and calling yourself queer. There are dead people shouting inside you. You have got to shut up your mother. There she is, quivering away inside you, screeching at you." I hear her voice on the phone, hear her voice at thirteen. "The family is a dead area inside our skulls," O'Rourke resumes. "Drop your endless capacity for punishment. Let yourself. Do. They cannot punish you, the voices inside. Stifle them."

I hadn't looked at this passage in a long time, probably more than twenty years. What I remembered was what O'Rourke said about anger, but when I first read it I was struck just as much by what she said about the punitive "voices ... "screeching at you" inside your head. These are not (necessarily) the kind of voices that go along with schizophrenia; I took them metaphorically as the echoes of everyone -- not just adults: peers too -- who do the job of keeping us within bounds. You can't think that. You can't say that. You can't do that. You can't dress like that. Boys don't cry. Nice girls don't do that. What are you, a fag? What are you, a slut? What are you, a nigger-lover? What are you, a commie?

Especially after having read Staub's book, I now detect echoes of Laingian antipsychiatry in O'Rourke's speech. At my age I'm less inclined to want to blame my family, or anyone else, for my inhibitions and guilt. Maybe I should read Laing, because I'd like to know if he took into account the fact that human beings are a social species; our vulnerability to our families comes from our prolonged infancy and childhood. We can't survive without the support and input, but also constraint, of other human beings. Those "voices" hold us up as well as crush us. From Staub's account of the antipsychiatrists, I gather they overlooked this.

I credit Dorothy Dinnerstein for at least implying this in her The Mermaid and the Minotaur (Harper, 1976), a flawed but still powerful book that had a big influence on me. She pointed out that infants and young children want everything, and with the best will in the world the most nurturing mother couldn't give them everything they want; they're too young to understand why they can't stay in the toy store forever, or run out into the street as they see grownups doing, or take home the things they see and want. This means to me that if growing up healthy means never being frustrated, no one could grow up healthy. And, of course, our parents also have their own wounds, and their own needs, they're the products of their own upbringing, so if I'm not to blame for my problems, neither are they.

Taking all this into account, O'Rourke's advice still looks good to me. For one thing, we selected the voices that screech at us from inside our heads. (Parents are often shocked to learn what their children remembered, as well as what they forgot.) This passage was a voice I kept in my head, and it helped me along through my later twenties and into my thirties. We also need to learn to ignore them, stifle them, outgrow them. Accept our anger, accept our fear, learn not to be stopped by them.

But this is also the problem with "mental illness," whether it refers to mild discomfort or major dysfunction, let alone dissenting opinions or personal styles that people too easily call "crazy." At the same time, though, becoming irrational and allowing oneself to rant and call for pitchforks and torches is considered proper behavior all through our society, provided we pick the right occasion and target for our craziness. (Staub discusses the way that mainstream commentators indulged in facile armchair psychoanalysis of student and other political dissenters in the 1960s, though most empirical studies showed student radicals to be well adjusted [for what that evaluation is worth]). Whether you view mental illness as a medical reality or a social construct -- which, again, are not mutually exclusive categories -- its boundaries are highly subjective, as are the possible remedies.

Which reminds me, here's a fine example that shows that the overreaching of scientists on social issues is still with us, and still good for news coverage. More about it later, if I get around to it, but for now, those researchers are obviously too dumb to be taken seriously; trust me on this, I'm an intellectual.

Father Knows Best

I just finished reading Michael E. Staub's Madness Is Civilization: When the Diagnosis Was Social, 1948-1980 (Chicago, 2011), which is an interesting account of the clash between the medical model of mental illness and the "social diagnosis" model in the United States during the decades right after World War II.

It just occurred to me that there's a parallel with the essentialist / social constructionist debates going on here, though Staub doesn't refer to that terminology. At times Staub seems to believe that the antipsychiatry movement of the Fifties and Sixties, exemplified by R. D. Laing and Thomas Szasz, held that there was no such thing as mental illness, though he also shows and seems to recognize that this is, at best, only partially true. There has been a lot of confusion about that question, though, as shown by a declaration Staub quotes from the Icarus Project, a "mad pride" collective: "Are we delusional and dysfunctional, or is it the culture we live in?" (192) As Staub documents throughout the book, this is a familiar idea: it weaves back and forth between denying that the concepts of madness and sanity/normality have any meaning at all, and declaring that I'm not sick, you are! -- which seems to concede the reality of "mental illness", but tosses it back and forth like a hot potato.

That's why I've always been ambivalent about this idea. I've read a fair amount of literature which holds that in an insane society, it's sane to be insane. (That's the premise of Doris Lessing's 1971 novel Briefing for a Descent Into Hell, for example, though it's also a theme in much of her fiction.) I'm inclined to think that sanity and normality may be relative to the situation, like Darwinian fitness: a trait that's adaptive in one environment may be maladaptive in another. But it also seemed to me that if the "mad" are really, as some have suggested (the questions are often more rhetorical than serious), gifted and superior beings, they should be able to function more successfully in an "insane" society than those of us who are putatively normal. Or maybe not: the real problem is that sanity and insanity are not very well-defined concepts, and even professionals are far too quick to label others as insane or mad or crazy -- not a whole lot better than laypeople. (As Staub also shows, "schizophrenia" is an ill-defined, hard-to-diagnose condition to this day, despite the ongoing claims that it's a medical, biological illness with a genetic base. I've long suspected that it will ultimately be defined circularly, as whatever condition responds well to a given treatment, and other conditions that don't, but which would have been confidently labeled schizoid in the past, will be defined as something else.)

Anyway, there's a lot of useful information in Madness Is Civilization, with a whole chapter largely devoted to the feminist revolt against the psychiatric/psychoanalytic establishment.

With disarming candor the psychoanalyst Theodore Reik – who had been trained by Sigmund Freud and who founded the National Psychological Association for Psychoanalysis in New York – repeatedly revealed that his female patients were unwilling to accept his insights into their states of mind. “When you listen to me a long time without saying anything, I often have the impression that what I say is silly woman’s stuff and without value,” one patient told Reik. “It is as if you do not consider it worth your while to speak to me.” Reik recollected how another female patient responded more sharply to his interpretations: “Goddam, I don’t know why I am here. Fuck yourself!” And a third female patient had this exchange with Reik: “When I told a patient in her forties that she had wanted to be a boy like her brother, she began to curse and abuse me, saying ‘Fuck you!’ and ‘Go to hell!’ and other unladylike expressions.” But these challenges to his authority did not cause Reik to doubt his own judgment. At no point did Reik allow for the possibility that outbursts from female patients reflected the legitimacy of their frustrations with him. (It was left to radical feminist Shulamith Firestone to point out that Reik’s commentaries read “like a Freudian jokebook.”) Yet by the early 1970s even the densest of analysts and other MDs could see that an extraordinary number of women were increasingly uncomfortable with their treatment.

Women in therapy were reportedly becoming so uncooperative that a proposal in 1971 sought to introduce a new diagnostic phenomenon. Called “the angry woman syndrome,” it described patients who took “fiendish delight in deriding their husbands” and who exhibited a “baleful disregard to decency.” These women were superficially well adjusted and successful in their lives, but they nonetheless “strike out blindly, frightened by any threat to their not being the sole center of attention.” In short, their behavior revealed patterns that “at times border on psychotic with paranoid and aggressive overtones.” In 1972 there was a second proposal for another new category of client called “the intractable female patient.” These were women who initially presented “exactly the kind of patient with whom the young resident in particular hopes to work.” But looks could be deceiving. In reality these women were supreme manipulators who used their feminine wiles to turn psychotherapy “into a quagmire from which escape is ever more difficult.” The psychiatric solution for the intractable female patient was for therapists to “set a firm discharge date reasonably early” and to insist that the husband “assume a posture of strength and resolution – especially toward his wife.” This was because the intractable female patient most desired to be dominated by men, the essay concluded, and though she might repeatedly test the resolve of men to dominate her, “she really hopes that she will not win” [144-45].

Here are some good examples of what I wrote earlier. Women who were angry at being confined by the narrow strictures of 1950s American femininity were not just labeled as sick, they were borderline psychotic. And you know it had to be true, because this was a scientific medical diagnosis, by the intellectual heirs of the Enlightenment and its values! Only an irrationalist would reject the authority of these men of science! In much the same way as today's evolutionary psychologists are embarrassed by and try to dissociate themselves from the racist and sexist eugenics of the earlier twentieth century, today's scientific psychiatrists probably prefer to forget this period in their field. The question for the layperson, though, remains what it was sixty years ago: how am I to tell whether today's practitioner really has a sound basis for his or her diagnosis -- or will it look just as embarrassing a few decades from now as "the intractable woman"? It's like asking a theist why I should believe in his or her god, but not in someone else's.

I'm not rejecting the medical model of mental illness out of hand, you understand. It may well be useful in some cases. But the burden of proof lies on the person who advocates the medical model, and a sharp, informed skepticism toward such a person's claims is not just appropriate, it's obligatory.