Dave Russell on

Anthony James'
Amputated Souls -The Psychiatric Assault on Liberty 1935-2011
Imprint Academic 2013 ISBN 9781845404505 £9.95

A work which pulls no punches, concentrating on the use of ECT and lobotomy, and exploring these phenomena in relation to social and political structures, and to important literary figures.

Amputated Souls is based on painstaking research, and the consultation of major authorities, such as Professor Colin Blakemore, whose lectures in this area were published in The Listener. According to Blakemore: “The present-day use of convulsive therapy stems from a revival of the 18th century opinion that maniacs were best treated by a very severe physical stress, and from the entirely erroneous view that epileptics are protected from schizophrenia by their natural convulsions.”

As a definition of lobotomy, he quotes the words of Dr Jacob Bronowski:

“We do not know exactly what the frontal lobes may do. We do not know anything very exactly . . . they make behaviour into patterns. They take the past and pattern it so that it is usable for the future. They organize behaviour. If you do an operation, as people foolishly did, twenty or thirty years ago, in which you cut off the frontal lobes from the rest of the brain, you get an extremely happy animal that you still call a man, but which is quite incapable of making any future-directed decision.”

Brain surgery is hazardous to the extreme: “. . . while there is now considerable knowledge of the function of individual parts of the brain, the way in which the brain works as a total system in all its varied aspects . . . remains almost a mystery.” (36)

The practice of lobotomy originated in a reaction to an experiment on two chimpanzees by C Jacobsen and J.F. Fulton. The Portuguese neurosurgeon Egas Moniz used this ‘prompt’ to perform comparable experiments on human beings. He claimed that out of 27 operations, 7 recovered and 7 removed. As the author points out, criteria of improvement and recovery can be subjective. Dubious indeed!

Because of this ignorance, in the words of Peter R Breggin, “Instead of offering human understanding, psychiatry has fabricated biological and genetic explanations . . . to justify a massive drug assault that has taken a profound toll in terms of damaged brains and shattered lives.”

Anthony James writes in depth from his experience in a drug advice unit in the mid-1980s, when the abuse of medications, particularly psychiatric ones, started coming to light. He rightly points out that all psychiatric medications can be addictive, and that none of them are without side-effects. It is good to be informed of the British National Formulary (BNF) reference work which deals with these aspects, and is available to the public.

Anthony gives a fully detailed report of someone who had been prescribed Largactil.

From his own experience, he explores the issue of ‘informed consent’. He had consulted a Dr Smith about depression, and prescribed various medications which proved ineffective. He rejected Dr Smith’s suggestion that he should enter hospital as a voluntary patient to ‘find the right drug’. Anthony felt that he had a lucky escape. Dr Smith was a charismatic personality, and could easily have pressurized him into undergoing ECT. Once in hospital, his status could easily have been changed from voluntary to sectioned patient. He goes on to describe how he was prescribed Chlorpromazine for five years, and then gives a tragic account of a voluntary patient who was ‘gently persuaded’ to give her consent for ECT – a sickening story indeed. Christopher Price MP, who wanted to ban ECT made an incisive observation: “There is widespread abuse of the consent procedures. If you say that you don’t want this treatment, the doctors say, ‘Oh yes, that is part of your illness, not wanting it.’”

“Therefore, as reliable evidence of incapacity to make a choice can never be found, any society that claims to uphold the freedom, integrity, and autonomy of the individual must always assume that capacity exists, just as a citizen accused of a crime is innocent until proved guilty . . . I would also suggest that the rejection of a particular form of treatment should not have to be ‘cogent’ or articulate: a simple ‘no’ should suffice.

We are reminded that that Ernest Hemingway had been subjected to ECT, which induced loss of memory, and possibly his suicide. A.E. Hotchner, a friend of Hemingway’s wife, recalls Hemingway’s own bitter words on the subject: “Well, what is the use of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure but we lost the patient.” This point is reinforced by the author: “. . . the Royal Commission that led up to the Mental Health Act was very clear on the point somebody who is mentally ill is not necessarily disabled.” But such a person could give an impression of being disabled, and psychiatrists could take advantage of that impression, which would render the patient vulnerable.

Rightful prominence is given to One Flew Over the Cuckoo’s Nest by Ken Kesey (1962). Reinforced by the powerful film version released in 1975, this work remains deeply entrenched in popular consciousness.

Plath’s The Bell Jar (1963) is largely autobiographical, written in the background of the execution of the Rosenbergs as Soviet spies. Plath is highly critical, through the fictional filter, of her own psychiatrist. Significantly, the real life psychiatrist ignored Sylvia’s desperate plea for her to come to London during the months leading up to the suicide.

Faces in the Water (1961) and An Angel at My Table (1984) by Janet Frame. Some powerful work by a writer from New Zealand, a country which has generally been respected for its enlightened and tolerant attitudes. Nobody as articulate as Janet emerged from the UK psychiatric system at that time.

Girl, Interrupted by Susanna Kaysen (1993). Susanna attended McLean Hospital (which Sylvia Plath had attended 10 years previously). She ‘signed away her rights’ by entering the hospital voluntarily under the false threat of a court order (akin to UK sectioning procedure). Kaysen made a radical step of obtaining her hospital files via a lawyer, and using this as the basis for an attack on the psychiatric system. Her committal was strongly related to fears of youth rebelliousness in the early 1960s.

In Two Minds (1967) and Family Life (1972), by David Mercer. The former is a television play, the latter a film, telling the same story ‘although the order in which incidents happen and the characters themselves differ significantly in each work.’ The theme is that of a young girl with a domineering mother who, amongst other impositions, makes her daughter have an abortion, whilst hypocritically proclaiming the criminality of abortion. “Is it surprising that someone who is subtly controlled by parental disapproval and by internalized guilt for years begins to feel that she is a robot controlled from a distance?” A sympathetic psychiatrist is thwarted in his attempt to guide Kate/Janice to independence of mind.

The Divided Self, R D Laing (1960). In the author’s opinion “Laing’s later work deteriorated as he fashionably described those suffering from psychosis as sane people in an insane world, so that the methods he used in an alternative refuge for patients became increasingly dangerous and irresponsible.”

Anthony James unflinchingly outlines the affinities between psychiatric abuses in the ‘civilised, democratic’ Western world and the measures adopted in Nazi Germany and the Soviet Union. Re the UK, he discusses in detail the atrocities perpetrated by Dr William Sargant, who in 1940 established a psychiatric unit where he experimented on soldiers. The Ministry of Defence ordered him to keep his findings secret. He was given a free hand to administer ECT, and some of his patients died. He was never brought to justice.

The 5th chapter relates to the author’s personal experiences. 1974 was a stressful year for him, and coincided with the death of Jacob Bronowski, the expulsion of Alexander Solzhenitsyn and the resignation of Nixon. In his state of depression, he was prescribed several medications which proved ineffectual. Anthony’s psychiatrist, Dr Smith suggested that he went to hospital as a voluntary patient. James challenges the label of Bi-Polar-Affective Disorder.

The concluding chapter makes an astute comparison between psychiatric abuse and rape, suggesting that psychiatrists can get sadistic pleasure from their ministrations. A final plea for freedom and independence of thought: “If we have blind faith in the authority and expertise of any elite within society, political, medical, or technical, we lose the ability to think clearly . . . There is no clear dividing line between psychotic illness and the inner anguish that we all experience at times.” There is a powerful reference to Dr Peter R Breggin who claims that some medical staff can get sado-erotic pleasure from administering brain operations.

In the words of one reviewer, James Maw “Anthony James uses clear language to lay out the story of the inhumane treatments that have blighted the reputation of modern psychiatry . . . This book should be read by anyone who is setting out on a career in psychiatry and has been given the standard texts to study. It will also be of invaluable help to those who were the patients, who so often feel isolated and alone in their experience.”

Dave Russell © 2014