Psychic Profiteering

...Because of this error in fundamentals, the whole machinery of these institutions is getting rapidly out of date...

...It is only decent that this fact should be frankly and courageously admitted and faced...

...Orr Edson, in his book, Getting What We Want, cites the case of a young girl whom he took from a public institution (where she would likely have spent the rest of her days but for his intervention) and brought round to normality in a matter of a few weeks simply by the application of a little common sense and human kindness...

...Whether or not they as a body yet "recognize" the theories of Freud and Jung or the researches of Swift, Edson, and other painstaking workers, it is clear enough even to the layman that the true line of endeavor in mental cases is something altogether different from what is found to be standard practice in many institutions, where patients might be stuffed and spray-bathed till the crack of doom without real or permanent benefit...

...We need expect nothing more than we actually find in many cases—people getting worse instead of better, becoming confirmed in their delusions instead of getting rid of them, and carrying the scars (mental and physical) of these experiences with them to the grave...

...We cannot, of course, hold the psychiatrist responsible for the economic system that puts him in so false a position, but on the other hand he must do his share in bringing about that better ordering of society for which there is such crying need...

...To surround a man who has become morbid or melancholy from real or fancied troubles with others who are more morbid or melancholy than himself is both foolish and dangerous...

...Shaw added, in his own inimitable fashion, that a collection of lunatics could hardly make a more ridiculous arrangement...

...Shakespeare, with his deeper knowledge of human nature, expressed the case much more properly when he said: " 'Tis the 435 mind that makes the body rich...

...An altogether false interpretation is put upon the adage about the sane mind and the sound body above referred to, and the originator of the saying, whether Latin sage or otherwise, would possibly be staggered at the modern attempts to apply the principle literally and in wholesale fashion to all kinds of mental cases, and at the preposterous supposition that you have simply to fatten a man, as you might fatten a hog or a goose, in order to remove nervous distress consequent upon financial troubles, an unfaithful wife, repression, or thwarted ambition...

...It is devoutly to be hoped, therefore, that psychology will get itself out of swaddling-clothes as speedily as possible and straighten out a situation that cannot continue much longer without results that will bring the whole body of psychiatrists into serious disrepute...

...The thing that (naturally enough) bulks most largely in their minds is their own bread and butter...

...The only alternative to the private profit-making sanitarium offered today to those mentally afflicted is the state hospital...

...He has got to see to it that the business man, with his eternal self-seeking, is not allowed to step in and commercially exploit the sufferings or the weaknesses of humanity, nor must he follow this course himself...

...If the institution does not pay they will lose their jobs...

...What is known as the "rest cure" consists for the most part in stuffing the patient with rich foods, giving him little or nothing to do that calls for the exercise of his mental faculties, and encouraging him toward physical endeavors in the way of walks or games...

...and negatively as regards those suffering from minor and temporary afflictions, who are simply left severely alone...

...Of course, as George Bernard Shaw pointed out long since, the same may be said to apply to the ordinary medical practitioner, who has every reason for hoping that people will fall ill and remain so, since if everyone keeps well he is bound to starve...

...The private sanitarium therefore is, and will continue to be until the right class of people take the matter in hand, the resort of the man or woman suffering a temporary breakdown, where (theoretically) they may rest secure from the rush and worry of the times, surrounded by every material and bodily comfort and convenience...

...Such an inducement, however, should most emphatically not be present or be allowed to play any part whatsoever in such decisions...

...To keep a full house means either a steady supply of new patients or keeping hold of patients already secured as long as possible...

...But that a fat body is something that is going to help mental troubles is a superstition that ought to receive its quietus forthwith...

...And for this they are possibly not altogether to blame...

...She had simply fallen into poverty and been too sorely thwarted in her dearest wishes...

...In plain English, a premium is put upon keeping hold of the patient as long as possible...

...It may as well be confessed too, since most of the doctors in sanitariums are well aware of it, that segregation with others similarly afflicted is just about the worst thing in the world for mental cases of the kind covered by the modern term "nervous breakdown...

...Only to a very limited extent can the body be said to enrich the mind...

...And even the most ardent champion of state ownership will scarcely contend that the state hospital, as we see it here and now, is the place to which we would care to commit those dear to us...

...What, then, is to be expected of the disordered or morbidly sensitive mind staggering beneath a load of real or fancied troubles, with reason itself trembling in the balance...

...The kindness, sympathy, understanding, and patience exhibited in the handling of that case command our respect and admiration, and shine forth with dazzling brightness amid all the humbug that calls itself "professional etiquette," laissez-faire, clinging to soft jobs, and do-nothingism in which psychiatry is meantime enshrouded...

...Such institutions are in the main places where our less fortunate brethren are experimented upon, positively in the case of those whose troubles are hereditary or traceable to the ravages of drink, drugs, or venereal disease, who are dosed and inoculated to the satisfaction of every new theory...

...The sights and scenes witnessed in these establishments as matters of every-day routine are harrowing in the extreme even to those in robust health, and the fact is well enough established that attendants and even doctors themselves frequently suffer by such contact...

...and where, far from the madding crowd, in a peaceful environment amid beautiful flowers and foliage, erring and unfortunate sons and daughters are gradually weaned away from their sorrows and reconciled to a tacit submission to their lot in life...

...He did not concern himself so much with the way in which her trouble manifested itself (she pranced about with uncouth noises in imitation of a horse) but went after the root cause of her distress which did not prove hard to discover...

...From the nature of the treatment that has been recognized as standard in mental cases for many years, such a procedure is not, as a rule, difficult of accomplishment...

...For let it be remembered that the man who is "committed" to such a place by well-meaning friends or relatives acting under "medical advice," is automatically stripped of all his civil rights and is as helpless as a child...

...A study of the methods of these sanitariums makes it clear enough that the doctors and officials in charge, finding themselves thus on the horns of a dilemma that is really bound up with our antiquated economic system and for which they do not feel themselves responsible, proceed along the lines of least resistance in dealing with the problem...

...Anger, expostulation, threats, and even tears, avail nothing, and indeed are but considered as further proof of mental aberration...

...And I think Mr...

...But a little investigation shows very clearly that to leave such enterprises in the hands of "merchant venturers" is fundamentally unsound, and that a good deal of adjustment is needed to bring them into line not only with the findings of psychoanalysis, but with the dictates of common sense...

...The point is too obvious to need laboring...

...and until the unfortunate patient learns that only by behaving in what is known as a "normal" fashion in such places (and where the standard came from heaven only knows) by eating heavily and putting on weight, lounging around doing nothing, walking soberly with ridiculous processions of his fellow-sufferers, or manifesting interest in games or sports which somebody else thinks it is his duty to like, can he hope to obtain the longed-for release, he will just have to bear his captivity with what patience he may...

...To state the case in another way, if the institutions cure their patients and send them home quickly they are in danger of going bankrupt...

...The sane mind in the sound body" is the basic maxim of this philosophy...

...The anguish occasioned to active and intellectual men (to say nothing of delicate and sensitive women) by this absurd line of action is often shocking in the extreme, as can readily be imagined...

...434 PSYCHIC PROFITEERING By J. B. M. CLARK THE question of how far it is possible to introduce the principle of profit-making with propriety into the handling of mental or psychic cases is one about which little is heard meantime, but which will undoubtedly press itself to the forefront as time goes on...

...and when to this is coupled fees of the appalling kind necessary to maintain the huge overhead charges involved in the running of such establishments, we need not wonder at finding the patient getting little comfort at the prospect of his life savings rapidly melting away, or in seeing his dear ones running themselves short to meet bills he knows it would be better not to incur...

...To begin with, it is apparent that establishments having as the primary cause of their existence the making of profits for private individuals, suffer at the outset from the serious handicap of having to concern themselves with dividends, an imposition that immediately tends to conflict with their curative functions, inasmuch as it is necessary to have such places well filled with patients in order to make them pay, and to keep these patients there as long as possible...

...A long process of time has always been assumed to be essential to such cures, so that a few weeks more or less in any individual case is generally a matter easy of arrangement, and in view of the revenue inducement quite a natural step...

...A healthy and vigorous mind can work wonders on a diseased body, as our psychiatrists might have learned by this time from Christian Science and faith healers...

...For if psychiatrists as a body do not tell us just what the trouble is and where the blame lies they will undoubtedly be called on sooner or later to shoulder the responsibility themselves...

...This to a certain extent the private sanitarium succeeds in doing...

...Since the supply of new patients is always an uncertain quantity and may generally be supposed to lie outside the sphere of influence of the officials in question, they naturally turn to the other alternative and strive to make the most of patients already secured...